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Individual

MERANDA L ADWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
8211 STERLING AVE, RAYTOWN, MO 64138-2647
(816) 536-1997
Mailing address
207 S EAST AVE, BELTON, MO 64012-3063
(816) 536-1997

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080302023
ATHLETIC TRAINER
Enumeration date
09/13/2017
Last updated
09/13/2017
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