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1265455398
PHILLIP L THREATT
COLUMBIA, MO
NPI
1265455398
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO 103540)
Enumeration Date
2006-07-26
Last Update Date
2015-03-18
Business Address
-- PHILLIP L THREATT ATC
3301 BERRYWOOD DR SUITE 204
COLUMBIA, MO 65201-6517
Phone number: 573-449-8771
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Mailing Address
-- PHILLIP L THREATT ATC
3301 BERRYWOOD DR SUITE 204
COLUMBIA, MO 65201-6517
Phone number: 573-449-8771
Copy
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