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General NPI Number Information
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NPI Number | 1508957234
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Entity Type | Individual
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Provider Name | BRAD ROBERT MCHUGH ATC
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Gender | Male
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1909 VICKI LN SUITE 108
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City | NORFOLK
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State | NE
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Zip | 68701-4542
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Country | US
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Telephone | 402-379-3777
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Fax | 402-379-3793
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Provider Business Mailing Address
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Address Line | 57044 837 RD
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City | STANTON
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State | NE
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Zip | 68779-7891
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Country | US
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Telephone | 402-439-2546
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Fax | 402-379-3793
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 277
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License Number State | NE
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