Individual
RANDALL SCOTT BAACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
800 N COLUMBIA AVE, SEWARD, NE 68434-1556
(402) 643-7420
Mailing address
110 LINCOLN ST, SEWARD, NE 68434-1533
(402) 643-6863
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
366
NE
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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