| NPI | 1639047210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT J MCQUEEN Owner 417-294-2716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2025-10-27 |
| Last Update Date | 2025-10-27 |