Individual
MR. RUSSELL JAMES MCKUNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
6001 DODGE ST, FH 024, OMAHA, NE 68182-0014
(402) 554-4997
Mailing address
18925 LILLIAN ST, OMAHA, NE 68136-1287
(402) 916-9477
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
173
NE
Other
Enumeration date
12/20/2006
Last updated
07/08/2007
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