Healthcare Provider Details
I. General information
NPI: 1457428997
Provider Name (Legal Business Name): ROBERT BROWNE ABO
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1101 S 70TH ST SUITE 200
LINCOLN NE
68510-4278
US
IV. Provider business mailing address
1101 S 70TH ST SUITE 200
LINCOLN NE
68510-4278
US
V. Phone/Fax
- Phone: 402-486-1556
- Fax: 402-486-3132
- Phone: 402-486-1556
- Fax: 402-486-3132
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 156FX1800X |
| Taxonomy | Optician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: