KELLEY LUCILLE WEIDINGER

JEFFERSON CITY, MO
NPI1093910812
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO  2007017252)
Enumeration Date2007-06-20
Last Update Date2007-07-08
Business Address
Miss KELLEY LUCILLE WEIDINGER ATC, LAT
3308 W EDGEWOOD DR STE F
JEFFERSON CITY, MO 65109-6891
Phone number: 573-638-3400
Mailing Address
Miss KELLEY LUCILLE WEIDINGER ATC, LAT
11820 MARIES ROAD 328
VIENNA, MO 65582-7123
Phone number: 573-680-3826