MEDICARE: KOBE LO MA, LAT, ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2255A2300X	Athletic Trainer	1191	NE

General Provider Information

NPI Number	:	1922941046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KOBE LO MA, LAT, ATC

Provider Business Mailing Address
First Line	:	1400 MINUTEMAN DRIVE
Second Line	:
City	:	LEXINGTON
State	:	NE
Zip	:	68850
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 MINUTEMAN DRIVE
Second Line	:
City	:	LEXINGTON
State	:	NE
Zip	:	68850
Country	:	US
Telephone Number	:	308-324-4691
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2026
Last Update Date	:	04/13/2026

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Directions to “ KOBE LO MA, LAT, ATC” Practice Location

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