Individual
STACIA WEAVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
8329 WEBER ST, OMAHA, NE 68122-1364
(402) 650-7322
Mailing address
8329 WEBER ST, OMAHA, NE 68122-1364
(402) 650-7322
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
269
NE
Other
Enumeration date
03/30/2014
Last updated
03/30/2014
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