Provider Demographics
NPI:1376762252
Name:MAYER, MARK (ATC)
Entity type:Individual
Prefix:MR
First Name:MARK
Middle Name:
Last Name:MAYER
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ONE MEMORIAL STADIUM
Mailing Address - Street 2:UNIVERSITY OF NEBRASKA
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68588-0128
Mailing Address - Country:US
Mailing Address - Phone:402-472-9871
Mailing Address - Fax:
Practice Address - Street 1:ONE MEMORIAL STADIUM
Practice Address - Street 2:UNIVERSITY OF NEBRASKA
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68588-0128
Practice Address - Country:US
Practice Address - Phone:402-472-9871
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer