Individual
JERAD BRUGGEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
500 COLLEGE HL, LIBERTY, MO 64068-1843
(816) 415-5954
Mailing address
500 COLLEGE HL, LIBERTY, MO 64068-1843
(816) 415-5954
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
MO
Other
Enumeration date
04/22/2016
Last updated
04/22/2016
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