Provider Information for 1790251767
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PAMELA GALLES
Sex: Female
NPI: 1790251767
Last Updated: 2018-10-17
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1790251767 | ||||||||
| Enumeration Date | 2018-10-17 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 501 N 27TH ST COUNCIL BLUFFS, IA 51501-2121 United States Phone: | Fax: | ||||||||
| Primary Practice Address | 4318 FORT ST OMAHA, NE 68111-1849 United States Phone: 402-552-7020 | Fax: | ||||||||
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