Individual
FAWNTANA LECHELA VIERRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2025 N 67TH ST, OMAHA, NE 68104-4603
(402) 321-0537
Mailing address
2025 N 67TH ST, OMAHA, NE 68104-4603
(402) 321-0537
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
05/09/2025
Last updated
05/09/2025
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