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Individual

MELISSA NIENHUIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC

Contact information

Practice address
500 S KEENEY ST, COLE CAMP, MO 65325-1059
(660) 668-3751
Mailing address
8166 BOULDER RD, VERSAILLES, MO 65084-4939

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2016023475
MO

Other

Enumeration date
04/26/2020
Last updated
04/26/2020
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