Individual
TANGO TEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5609 1ST AVE APT B, KEARNEY, NE 68847-2438
(402) 699-4902
Mailing address
3719 D AVE, KEARNEY, NE 68847-8135
(405) 519-6057
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
372600000X
NE
Other
Enumeration date
01/12/2026
Last updated
01/12/2026
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