Individual
KIYA JORDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7778 N 149TH ST, BENNINGTON, NE 68007-5828
(402) 502-0723
Mailing address
7778 N 149TH ST, BENNINGTON, NE 68007-5828
(402) 502-0723
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
01/21/2025
Last updated
01/21/2025
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