Facts
- Status
- A
- Credential
- Au.D.
- Type
- Individual
- Enumeration date
- 2005-10-31
- Last updated
- 2020-10-30
Specialties
Licenses
- License TX
- 51662
Location
- Practice location
- 2501 CAPEHART RD
- City
- OFFUTT AFB NE
- Postal code
- 681131043
- Phone
- 402-294-7376
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.