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NPI 1730142787

NPI 1730142787 : AARON T SPENCER RN, ATC : OMAHA, NE

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General NPI Number Information
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    NPI Number           |    1730142787
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    Entity Type          |    Individual 
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    Provider Name        |    AARON T SPENCER RN, ATC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    04/10/2006
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    Last Update Date     |    06/14/2023
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Provider Practice Location Address
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    Address Line         |    4101 WOOLWORTH AVE 
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    City                 |    OMAHA
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    State                |    NE
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    Zip                  |    68105-1850
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    Country              |    US
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    Telephone            |    402-346-8800
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    17421 ERSKINE CIR 
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    City                 |    OMAHA
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    State                |    NE
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    Zip                  |    68116-2771
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    Country              |    US
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    Telephone            |    801-472-6424
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    Fax                  |    
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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       |    AL1800
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    License Number State |    FL
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