Individual
JOSHUA CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
11300 DUNN RD, SAINT LOUIS, MO 63138-1047
(505) 999-9290
Mailing address
5469 ROOSEVELT LOOP NE, RIO RANCHO, NM 87144-5218
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2023029993
MO
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
08/30/2021
Last updated
04/13/2025
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