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Individual

ELI RILEY BIRDSONG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
901 S NATIONAL AVE # PROF417, SPRINGFIELD, MO 65897-0027
(573) 578-9299
Mailing address
22251 STATE ROUTE P, NEWBURG, MO 65550-9116

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
MO
390200000X
Student in an Organized Health Care Education/Training Program
Primary
MO

Other

Enumeration date
06/10/2026
Last updated
06/10/2026
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