Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 1530 | NE |
NPI | 1336691385 |
---|---|
Provider Name | Lorela Paronable |
First Address | Omaha, NE 68116-2348 |
Second Address | Omaha, NE 68116-2348 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2016 |
Last Update Date | 25/10/2016 |