Individual
KEENE FULTON TIEDEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10007 S 9TH CIR, BELLEVUE, NE 68123-4023
(402) 680-2809
Mailing address
10007 S 9TH CIR, BELLEVUE, NE 68123-4023
(402) 680-2809
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
07/22/2025
Last updated
07/22/2025
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