Individual
MR. PADEN JEFFREY MAUDLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
811 N WALNUT ST, MARYVILLE, MO 64468-1353
(660) 541-0601
Mailing address
7933 N FLINTLOCK RD APT H, KANSAS CITY, MO 64158-1141
(832) 402-2385
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-01552
KS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
24-01552
KANSAS STATE BOARD OF HEALING ARTS
KS
Enumeration date
12/30/2016
Last updated
07/25/2021
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