Individual
TRACE THOMAS VAN BRIESEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7609 S 101ST ST, LA VISTA, NE 68128-8261
(402) 981-5547
Mailing address
7609 S 101ST ST, LA VISTA, NE 68128-8261
(402) 981-5547
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
03/10/2025
Last updated
03/10/2025
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