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General NPI Number Information
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NPI Number | 1194822130
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Entity Type | Organization
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Legal Business Name | ENT SERVICES PC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 10/14/2011
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Provider Practice Location Address
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Address Line | 555 N 30TH ST
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City | OMAHA
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State | NE
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Zip | 68131-2136
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Country | US
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Telephone | 402-498-6509
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Fax | 402-498-6357
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Provider Business Mailing Address
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Address Line | 555 N 30TH ST
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City | OMAHA
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State | NE
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Zip | 68131-2136
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Country | US
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Telephone | 402-498-6509
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Fax | 402-498-6357
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Authorized Official
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Title or Position | CORPORATE SECRETARY
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Name | MS. LEIGH JEAN KOINZAN
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Credential |
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Telephone | 402-498-6617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KA0200X
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Taxonomy Name | Allergy Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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