Individual
MANDY MCCARTHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
45623 SPOTTED TAIL RD, NEWPORT, NE 68759-5575
(605) 842-5838
Mailing address
45623 SPOTTED TAIL RD, NEWPORT, NE 68759-5575
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000032956
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS
—
Enumeration date
06/21/2018
Last updated
06/21/2018
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