Individual
ANDY TRUJILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, NCTMB
Contact information
Practice address
2903 W 24TH ST, KEARNEY, NE 68845-4925
(308) 234-9613
(308) 234-9614
Mailing address
22 W 56TH ST STE 107, KEARNEY, NE 68847-0508
(308) 234-9613
(308) 234-9614
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1982
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1982
STATE OF NEBRASKA - MASSAGE THERAPY ESTABLISHMENT
NE
Enumeration date
09/06/2011
Last updated
09/06/2011
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