Individual
KENNA DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4331 S FREMONT AVE, SPRINGFIELD, MO 65804-7328
(417) 820-5010
Mailing address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2000
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2015041556
MO
Other
Enumeration date
01/23/2017
Last updated
01/23/2017
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