Individual
BROOKSY LEE HALTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATHLETIC TRAINER
Contact information
Practice address
1706 PROSPECT DR, MACON, MO 63552-2615
(660) 385-1006
(660) 385-1028
Mailing address
1706 PROSPECT DR, MACON, MO 63552-2615
(660) 385-1006
(660) 385-1028
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2011028292
MO
Other
Enumeration date
03/25/2013
Last updated
03/25/2013
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