Provider Demographics
NPI:1215122882
Name:UNO ATHLETIC TRAINING SERVICES
Entity type:Organization
Organization Name:UNO ATHLETIC TRAINING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEAD ATHLETIC TRAINER
Authorized Official - Prefix:MR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MCKUNE
Authorized Official - Suffix:
Authorized Official - Credentials:ATC
Authorized Official - Phone:402-554-2774
Mailing Address - Street 1:6001 DODGE ST, FH24
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68182
Mailing Address - Country:US
Mailing Address - Phone:402-554-4997
Mailing Address - Fax:
Practice Address - Street 1:6001 DODGE ST, FH24
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68182
Practice Address - Country:US
Practice Address - Phone:402-554-4997
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty