Individual
KRISTEN DAVERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1600 UNIVERSITY AVE, MEYER WELLNESS CENTER, BOLIVAR, MO 65613-2578
(417) 777-7763
Mailing address
2224 W AUBURN ST, BOLIVAR, MO 65613-3204
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2012020080
MO
Other
Enumeration date
04/21/2016
Last updated
04/21/2016
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