| NPI | 1558503433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WADE WELTON Director,Sports Med/Ath Training 660-248-6217 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MO 102437) |
| Enumeration Date | 2009-03-24 |
| Last Update Date | 2009-03-24 |