Individual
RUSSELL ULRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
575 S 70TH ST, STE #200, LINCOLN, NE 68510-2471
(402) 380-2249
Mailing address
1801 S 42ND ST, LINCOLN, NE 68506-1112
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
413
NE
Other
Enumeration date
06/17/2016
Last updated
06/17/2016
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