Individual
ALEXA DECLUE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
901 S NATIONAL AVE, SPRINGFIELD, MO 65897-0027
(417) 836-5461
Mailing address
1735 W BENNETT ST APT G103, SPRINGFIELD, MO 65807-7843
(816) 645-8342
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/07/2018
Last updated
08/07/2018
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