Individual
REBECCA LYN WARDLAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, MA, LAT
Contact information
Practice address
12809 W DODGE RD, OMAHA, NE 68154-2155
(402) 206-1945
Mailing address
13312 JAYNES PLZ APT 305, OMAHA, NE 68164-1059
(402) 499-5260
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
441
NE
Other
Enumeration date
02/09/2009
Last updated
02/09/2009
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