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1922581867
NICHOLAS JOHN LEGRAND
SPRINGFIELD, MO
NPI
1922581867
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO 2018026636)
Enumeration Date
2018-09-06
Last Update Date
2018-09-06
Business Address
NICHOLAS JOHN LEGRAND ATC, LAT
1111 N GLENSTONE AVE
SPRINGFIELD, MO 65802-2125
Phone number: 573-579-8968
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Mailing Address
NICHOLAS JOHN LEGRAND ATC, LAT
4355 S NATIONAL AVE APT 712
SPRINGFIELD, MO 65810-2653
Phone number: 573-579-8968
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