Individual
BRIANA FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
6401 CHIPPEWA ST, APT 2E, SAINT LOUIS, MO 63109-2103
(417) 559-0274
Mailing address
6401 CHIPPEWA ST, APT 2E, SAINT LOUIS, MO 63109-2103
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2014026470
MO
Other
Enumeration date
12/14/2015
Last updated
12/14/2015
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