Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 1788 | NE |
Y | 111NP0017X | Pediatric Chiropractor | 1788 | NE |
NPI | 1174900799 |
---|---|
Provider Name | Andrew Kamerman |
First Address | Omaha, NE 68154-2630 |
Second Address | Omaha, NE 68154-2630 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2015 |
Last Update Date | 04/05/2015 |