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-- JACOB JAMES RIDDER -- PA-C

Individual Provider (NPI-1) Active

Physician Assistant, Medical

Provider Information

NPI Number
1508291717
Provider Type
Individual Provider (NPI-1)
Credentials
PA-C
Status
Active

Contact & Location

Address
12910 PIERCE ST STE 120, OMAHA, NE, 681441106
Phone
(402) 933-3770
Fax
(402) 933-3633

Specialties & Taxonomies

Dermatology License: NE #1768
Physician Assistant, Medical License: IA #002439
Physician Assistant, Medical Primary License: NE #1768

All Addresses

MAILING

12910 PIERCE ST STE 120

OMAHA, NE, 681441106

(402) 933-3770

LOCATION

12910 PIERCE ST STE 120

OMAHA, NE, 681441106

(402) 933-3770