Organization
EVANGEL UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARISA FOLTZ ATC, LAT (HEAD ATHLETIC TRAINER)
(417) 865-2815
Entity
Organization
Contact information
Practice address
1111 N GLENSTONE AVE, ASHCROFT BUILDING, SPRINGFIELD, MO 65802-2125
(417) 865-2815
Mailing address
1111 N GLENSTONE AVE, SPRINGFIELD, MO 65802-2125
(417) 865-2815
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
2014021703
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1184022501
ATC
MO
01
—
1659769768
ATC
MO
01
—
1700238615
ATC
MO
01
—
1982055901
ATC
MO
Enumeration date
07/19/2016
Last updated
07/19/2016
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