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Individual

STACI WORM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MOT, OTR/L

Contact information

Practice address
372 S 9TH ST, DAVID CITY, NE 68632-2116
(402) 367-1200
(855) 681-9015
Mailing address
456 N 8TH ST, DAVID CITY, NE 68632-1708
(402) 641-1501
(855) 681-9015

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
1932
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1932
OCCUPATIONAL THERAPIST
NE
Enumeration date
09/21/2015
Last updated
09/21/2015
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