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1447734876
KALEN JERRELL DAVIS
SPRINGFIELD, MO
NPI
1447734876
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO 2018033678)
Enumeration Date
2018-09-21
Last Update Date
2018-09-21
Business Address
KALEN JERRELL DAVIS LAT, ATC
1640 E GRAND ST
SPRINGFIELD, MO 65804-0213
Phone number: 573-337-0110
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Mailing Address
KALEN JERRELL DAVIS LAT, ATC
1640 E GRAND ST
SPRINGFIELD, MO 65804-0213
Phone number: 573-337-0110
Copy
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