Individual
IZAAC KITSMILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
3215 CUMING ST, OMAHA, NE 68131-2000
(308) 383-3716
Mailing address
1530 FAIRFIELD ST, LINCOLN, NE 68521-1648
(308) 383-3716
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
867
NE
Other
Enumeration date
10/13/2017
Last updated
10/13/2017
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