Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 981 | NE |
NPI | 1548469364 |
---|---|
Provider Name | Dr. Earl John Welbes |
First Address | Bellevue, NE 68005-5245 |
Second Address | Bellevue, NE 68005-5245 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2007 |
Last Update Date | 12/07/2007 |