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Carl Thomas Frank

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NPI Number Detailed Information

Provider Information:

Name: Carl Thomas Frank
Gender: M
Provider License Number If Given: 11319

NPI Information:

NPI: 1669471173
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 7/18/2005

Last Update Date: 7/8/2007

Provider Business Mailing Address:

Address: 16909 LAKESIDE HILLS CT LAKESIDE PROF CRT N STE 200
Omaha, NE 68130
Phone Number: 4025715323
Fax Number: 4025712495

Provider Business Practice Location Address:

Address: 16909 LAKESIDE HILLS CT LAKESIDE PROF CRT N STE 200
Omaha, NE 68130
Phone Number: 4025715323
Fax Number: 4025712495

Provider Taxonomy:

Primary: 174400000X
Secondary (if any): 174400000X
State: NE

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