Individual
MS. LARA DOESCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
411 CENTRAL METHODIST SQ, FAYETTE, MO 65248-1104
(660) 248-6978
Mailing address
411 CENTRAL METHODIST SQ, FAYETTE, MO 65248-1104
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2015026271
MO
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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