Individual
PABEBYAM RICHARD TIENDREBEOGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5802 S 167TH AVE, OMAHA, NE 68135-2396
(646) 702-3672
Mailing address
5802 S 167TH AVE, OMAHA, NE 68135-2396
(646) 702-3672
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
02/26/2025
Last updated
02/26/2025
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