Individual
ISALINE BIEN INECHA TOE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12125 S 204TH AVE, GRETNA, NE 68028-4080
(631) 248-1258
Mailing address
12125 S 204TH AVE, GRETNA, NE 68028-4080
(631) 248-1258
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/27/2025
Last updated
02/27/2025
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