Individual
MR. MITCHELL DEAN HAUSCHILDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, ATC, CSCS
Contact information
Practice address
4331 S FREMONT AVE, HEALTHTRACKS SPORTS TRAINING CENTER, SPRINGFIELD, MO 65804-7328
(417) 820-5010
(417) 820-5022
Mailing address
2308 LUNAR ST, REPUBLIC, MO 65738-1759
(417) 732-2843
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2002007678
MO
Other
Enumeration date
11/07/2005
Last updated
08/14/2007
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