Pioneer Totaltrade Medical Alarm Medical Nutrition Therapy Systems, Ll

NPI #1235360033 in Omaha, Nebraska

Provider Information

NPI Number: 1235360033
Entity Type: Organization
Organization Name: Pioneer Totaltrade Medical Alarm Medical Nutrition Therapy Systems, Ll
Primary Specialty: Nutritionist
Enumeration Date: Jul 29, 2009
Last Updated: Jul 29, 2009

Practice Location

Address: 2505 N 24TH ST
Address 2: STE 310
City: Omaha
State: Nebraska
ZIP Code: 68110-2252
Phone: (402) 403-5700

Authorized Official

Name: MR. RAPHAEL ADAMS OVONLEN, LMNT
Title: CEO
Phone: (402) 403-5700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nutritionist	133N00000X	Primary

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