| NPI | 1114105327 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY E HAINES Head Athletic Trainer 573-592-4388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2002005841) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2008-02-11 |