Individual
JORDAN RACHELLE VANNESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
398 BLUE JAY DR, LIBERTY, MO 64068-1977
(816) 407-2315
Mailing address
209 ESSEX DR, SMITHVILLE, MO 64089-8395
(573) 330-7007
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2016025471
MO
Other
Enumeration date
09/09/2020
Last updated
09/09/2020
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