Individual
MISS MAELYNN MOORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
6001 DODGE ST, OMAHA, NE 68182-1102
(402) 554-4997
Mailing address
6349 CEDAR PLZ APT 311, OMAHA, NE 68106-2289
(785) 640-9356
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1009
NE
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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