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Individual

SPENSER DEEKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3308 W EDGEWOOD DR STE F, JEFFERSON CITY, MO 65109-6891
(573) 638-3400
Mailing address
1177 HAMPTON LN, CALIFORNIA, MO 65018-9131
(573) 694-5156

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2016012510
MO

Other

Enumeration date
10/21/2014
Last updated
01/23/2017
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