Individual
MR. TREVOR MITCHELL POLIVKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8100 N 1ST ST, LINCOLN, NE 68531-8924
(402) 937-2662
Mailing address
8100 N 1ST ST, LINCOLN, NE 68531-8924
(402) 937-2662
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
H13496390
NE
Other
Enumeration date
03/27/2017
Last updated
03/29/2017
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