Individual
MIA BALTZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
2725 S 144TH ST, OMAHA, NE 68144-5243
(402) 609-3000
Mailing address
931 S 249TH ST, WATERLOO, NE 68069-4441
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1337
NE
Other
Enumeration date
07/17/2026
Last updated
07/17/2026
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