Individual
ALEX HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1600 UNIVERSITY AVE, BOLIVAR, MO 65613-2578
(417) 328-5281
Mailing address
PO BOX 173, DEPUE, IL 61322-0173
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/29/2017
Last updated
06/29/2017
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