Individual
MR. MICHAEL SCOTT MCCUISTION
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
LINCOLN EAST HIGH SCHOOL, 1000 S. 70TH ST, LINCOLN, NE 68510-4297
(402) 436-1313
(402) 436-1331
Mailing address
1000 S. 70TH ST, LINCOLN EAST HIGH SCHOOL, LINCOLN, NE 68510-4297
(402) 436-1313
(402) 436-1331
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
088
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
088
ATHLETIC TRAINER
NE
Enumeration date
05/01/2014
Last updated
05/01/2014
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