Individual
MS. EMELIA S. WHITEAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, PES
Contact information
Practice address
800 S ASH ST, NEVADA, MO 64772-3223
(417) 448-3990
Mailing address
800 S ASH ST, NEVADA, MO 64772-3223
(417) 448-3990
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2008029025
MO
Other
Enumeration date
07/23/2013
Last updated
07/23/2013
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