Individual
TANNER VEJRASKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 S NATIONAL AVE # PROF160, SPRINGFIELD, MO 65897-0027
(417) 836-8924
Mailing address
901 S NATIONAL AVE # PROF160, SPRINGFIELD, MO 65897-0027
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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