Individual
MAKEDA RUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2927 S 148TH ST, OMAHA, NE 68144-3257
(402) 277-0540
Mailing address
2927 S 148TH ST, OMAHA, NE 68144-3257
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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