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Organization
MISSOURI STATE UNIVERSITY ATHLETIC MEDICAL AND REHABILITATION SERVICES
Active
Organization
MISSOURI STATE UNIVERSITY ATHLETIC MEDICAL AND REHABILITATION SERVICES
Active
Other names
Missouri State University Athletic Training Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES THOMAS PENKALSKI ATC (DIRECTOR)
(417) 836-5461
Entity
Organization
Contact information
Practice address
901 S NATIONAL AVE, SPRINGFIELD, MO 65897-0027
(417) 836-5461
(417) 836-6101
Mailing address
901 S NATIONAL AVE, SPRINGFIELD, MO 65897-0027
(417) 836-5461
(417) 836-6101
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/13/2006
Last updated
04/01/2010
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