Individual
MR. OWEN RAY ISEMINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
715 E 19TH ST, KEARNEY, MO 64060-8453
(816) 500-3366
Mailing address
715 E 19TH ST, KEARNEY, MO 64060-8453
(816) 500-3366
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2010027802
MO
Other
Enumeration date
07/31/2014
Last updated
07/31/2014
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