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Individual

MR. JOHN JEROME BARRETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS, ATC, CES

Contact information

Practice address
633 EMERSON RD STE 20, CREVE COEUR, MO 63141-6739
(314) 325-3068
(314) 325-3069
Mailing address
5316 ZAMORA DR, SAINT LOUIS, MO 63128-3520
(314) 200-9540

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2017031789
MO
2255A2300X
Athletic Trainer
AL 1824
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
069702613
NATA BOC CERTIFICATION
01
2017031789
STATE OF MISSOURI ATHLETIC TRAINER LICENSE
MO
Enumeration date
06/16/2006
Last updated
01/24/2019
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