Individual
COURTNEY AILEEN DETRINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, LAT, ATC
Contact information
Practice address
107 S PROVIDENCE RD, COLUMBIA, MO 65203-4263
(573) 507-8342
Mailing address
107 S PROVIDENCE RD, COLUMBIA, MO 65203-4263
(813) 909-3178
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/29/2020
Last updated
02/23/2022
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