Individual
TATEN BRENT SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2501 CAPEHART RD, OFFUTT AFB, NE 68113-1043
(402) 294-6033
Mailing address
3056 PEASE DR, BELLEVUE, NE 68123-1424
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
03/15/2019
Last updated
03/15/2019
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