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Individual

STEPHANNIE JO MACA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
5120 MAPLE ST, OMAHA, NE 68104-3555
(402) 366-2561
Mailing address
7526 N 279TH ST, VALLEY, NE 68064-8046
(402) 366-2561

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
428
NE

Other

Enumeration date
06/13/2020
Last updated
06/13/2020
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