Individual
MR. JASON CLIFFORD HALVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, ATC, CSCS
Contact information
Practice address
1600 UNIVERSITY AVE, BOLIVAR, MO 65613-2578
(417) 328-2070
Mailing address
1305 S VILLAGE LN, BOLIVAR, MO 65613-2793
(417) 326-4587
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2004001637
MO
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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