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General NPI Number Information
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NPI Number | 1144741406
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Entity Type | Organization
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Legal Business Name | MULTICARE MEDICAL GROUP PC
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Dates
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Enumeration Date | 06/27/2017
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 701 PINNACLE DR STE 105
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City | PAPILLION
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State | NE
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Zip | 68046-6228
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Country | US
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Telephone | 402-505-7989
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Fax | 402-932-8863
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Provider Business Mailing Address
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Address Line | 741 PINNACLE DR
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City | PAPILLION
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State | NE
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Zip | 68046-6269
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Country | US
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Telephone | 402-505-7989
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Fax | 402-932-8863
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | DR. TONYA L BOECKENHAUER
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Credential | DC
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Telephone | 402-505-7989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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