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1396382024
JEREMY LANCE EDGERSON
LEES SUMMIT, MO
NPI
1396382024
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO 2019005566)
Enumeration Date
2019-12-02
Last Update Date
2019-12-02
Business Address
Mr. JEREMY LANCE EDGERSON ATC, CCMA
120 NE SAINT LUKES BLVD STE 200
LEES SUMMIT, MO 64086-6011
Phone number: 816-246-4302
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Mailing Address
Mr. JEREMY LANCE EDGERSON ATC, CCMA
10812 FREMONT AVE
KANSAS CITY, MO 64134-2502
Phone number: 816-520-9965
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