Individual
LIESA SWANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5019 N 209TH AVE, ELKHORN, NE 68022-5292
(402) 880-8506
Mailing address
5019 N 209TH AVE, ELKHORN, NE 68022-5292
(402) 880-8506
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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