Individual
DR. LISA A MUTZENBERGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
435 S 13TH ST, TEKAMAH, NE 68061-1307
(402) 374-1900
Mailing address
435 S 13TH ST, TEKAMAH, NE 68061-1307
(402) 374-1900
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1106
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47078788500
—
NE
Enumeration date
05/19/2006
Last updated
07/31/2007
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