Individual
ALIA WARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LAT ATC CES FMS
Contact information
Practice address
4280 TYNDALL AVE, NELLIS AFB, NV 89191-6056
(000) 000-0000
Mailing address
4280 TYNDALL AVE, NELLIS AFB, NV 89191-6056
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05065016
NEVADA BOARD OF ATHLETIC TRAINERS
NV
01
—
284921
ATHLETIC TRAINING BOARD OF CERTIFICATION
—
Enumeration date
07/28/2015
Last updated
06/10/2021
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