Organization
MISSOURI STATE UNIVERSITY ATHLETIC TRAINING SERVICESIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IVAN EUGENE MILTON A.T. (DIRECTOR ATHLETIC TRAINING SERVICES)
(417) 836-5461
Entity
Organization
Contact information
Practice address
901 S NATIONAL AVE, SPRINGFIELD, MO 65804-0027
(417) 836-5461
(417) 836-6101
Mailing address
901 S NATIONAL AVE, SPRINGFIELD, MO 65804-0027
(417) 836-5461
(417) 836-6101
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
MO
Other
Enumeration date
02/08/2006
Last updated
08/22/2020
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