Domerlin Sodusta

NPI 1679978084 · on the registry since 2014 · sole proprietor

Practice

Address: 4905 S 107th Ave
Suite 206
Omaha, NE 68127
Phone: (402) 968-1643
Organisation at this address: Llb Laser Llc
Serenecare Inc
Keen Minds Llc
Charter Hospice Of Omaha, Llc
Charter Home Health Of Omaha, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 10

Registry record

Primary taxonomy: 332B00000X
332B00000X
Licence states on file: NE
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2014-10-28

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Nebraska