| NPI | 1225310204 |
|---|---|
| Doing Business As | NORTHWEST MISSOURI STATE |
| Entity Type | Organization |
| Authorized Contact | MATTHEW CANNELLA Head Athletic Trainer 660-562-1313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2022-02-21 |