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General NPI Number Information
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NPI Number | 1689062895
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Entity Type | Organization
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Legal Business Name | GOOD HANDS CLINIC PC
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Dates
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Enumeration Date | 12/23/2014
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Last Update Date | 02/16/2015
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Provider Practice Location Address
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Address Line | 524 SOUTH WEBB RD SUITE 1
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City | GRAND ISLAND
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State | NE
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Zip | 68803
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Country | US
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Telephone | 308-675-2255
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Fax | 308-675-2348
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Provider Business Mailing Address
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Address Line | 524 SOUTH WEBB RD STE 1
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City | GRAND ISLAND
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State | NE
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Zip | 68803
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Country | US
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Telephone | 308-675-2255
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Fax | 308-675-2348
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Authorized Official
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Title or Position | OWNER
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Name | DR. MAYRA L ZENO
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Credential |
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Telephone | 308-675-2255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 18725
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License Number State | NE
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