Individual
MR. DANIEL RACKOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
13537 BARRET PKWY DR, 105, BALLWIN, MO 63021
(314) 821-9126
Mailing address
1256 WOODCHASE LN, APARTMENT F, CHESTERFIELD, MO 63017
(314) 306-1084
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2013004251
MO
Other
Enumeration date
08/13/2014
Last updated
08/13/2014
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