| Organization Name: | LONE TREE MEDICAL ASSOCIATES, P.C. |
| NPI Number: | 1700991510 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEVEN SCOT MAHNKE (CORPORATE OFFICER) |
| Mailing Address: | 2510 18th Ave Central City |
| State: | NE US |
| Postal Code: | 688262123 |
| Phone Number: | 3089463845 |
| Fax Number: | 3089462357 |
| NPI Enumeration Date: | 08/20/2006 |
| NPI Last Update Date: | 11/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |