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1073504783
JIM RAYNOR
SPRINGFIELD, MO
NPI
1073504783
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO 109104)
Enumeration Date
2005-11-02
Last Update Date
2007-07-08
Business Address
Mr. JIM RAYNOR ATC
1235 E CHEROKEE ST
SPRINGFIELD, MO 65804-2203
Phone number: 417-820-7990
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Mailing Address
Mr. JIM RAYNOR ATC
5329 S FERGUSON AVE
SPRINGFIELD, MO 65810-2597
Phone number: 417-881-6191
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