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NPI 1790666907

NPI 1790666907 : ALAN MORAVA : GRAND ISLAND, NE

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General NPI Number Information
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    NPI Number           |    1790666907
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    Entity Type          |    Individual 
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    Provider Name        |    ALAN MORAVA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/12/2025
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    Last Update Date     |    09/12/2025
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Provider Practice Location Address
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    Address Line         |    2208 N WEBB RD UNIT 4 
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    City                 |    GRAND ISLAND
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    State                |    NE
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    Zip                  |    68803-1756
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    Country              |    US
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    Telephone            |    308-381-1690
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    632 W 5TH ST 
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    City                 |    YORK
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    State                |    NE
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    Zip                  |    68467-2805
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    Country              |    US
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    Telephone            |    402-363-9671
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    372500000X
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    Taxonomy Name        |    Chore Provider
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    License Number       |    
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    License Number State |    NE
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