Provider Demographics
NPI:1851902647
Name:LIRA GARCIA, KATIA (MA, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:KATIA
Middle Name:
Last Name:LIRA GARCIA
Suffix:
Gender:F
Credentials:MA, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9153 BLACK ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-1823
Mailing Address - Country:US
Mailing Address - Phone:402-615-3071
Mailing Address - Fax:
Practice Address - Street 1:11335 S 204TH ST
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:NE
Practice Address - Zip Code:68028-7871
Practice Address - Country:US
Practice Address - Phone:402-615-3071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-13
Last Update Date:2021-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program