Individual
CLAYBORN BENNETT GALLOWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3301 BERRYWOOD DR STE 204, COLUMBIA, MO 65201-6517
(573) 449-8771
Mailing address
3301 BERRYWOOD DR STE 106A, COLUMBIA, MO 65201-6517
(573) 449-8771
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2023027470
MO
Other
Enumeration date
04/23/2024
Last updated
04/23/2024
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