Individual
MR. DWIGHT ERIC MCDONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
ONE CHAMPIONS DRIVE, STE. 100, COLUMBIA, MO 65211-0001
(573) 882-2375
Mailing address
3100 GREENBRIAR DR, COLUMBIA, MO 65203-3611
(573) 449-6843
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
TR000049
MO
Other
Enumeration date
06/27/2006
Last updated
07/08/2007
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