Organization
LISA MUTZENBERGER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA A MUTZENBERGER DC (OWNER)
(402) 374-1900
Entity
Organization
Contact information
Practice address
435 S 13TH ST, TEKAMAH, NE 68061-1307
(402) 374-1900
Mailing address
435 S 13TH ST, TEKAMAH, NE 68061-1307
(402) 374-1900
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1106
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098315
MEDICARE
NE
Enumeration date
07/10/2007
Last updated
04/20/2008
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