Organization
KHAZEN ATHLETIKARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORI ALLISON KHAZEN MS ATC, CSCS (OWNER)
(314) 368-9772
Entity
Organization
Contact information
Practice address
11892 WEXFORD PLACE DR, MARYLAND HEIGHTS, MO 63043-1763
(314) 368-9772
Mailing address
11892 WEXFORD PLACE DR, MARYLAND HEIGHTS, MO 63043-1763
(314) 368-9772
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000157569
MO
Other
Enumeration date
05/21/2007
Last updated
08/22/2020
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