Individual
JACQUILYN BRAZDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18480 CHICAGO CT APT 203, ELKHORN, NE 68022-7937
(402) 443-6370
Mailing address
18480 CHICAGO CT APT 203, ELKHORN, NE 68022-7937
(402) 443-6370
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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