Individual
ISAAC FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4331 S FREMONT AVE, SPRINGFIELD, MO 65804-7328
(417) 820-5010
Mailing address
835 S KICKAPOO ST, SPRINGFIELD, MO 65804
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000029478
BOC CERTIFICATION
—
Enumeration date
09/13/2016
Last updated
07/11/2017
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