Individual
DEREK ALLEN CLAYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4331 S FREMONT AVE, SPRINGFIELD, MO 65804-7328
(417) 820-5010
Mailing address
925 SOUTH AVE, SPRINGFIELD, MO 65806-3288
(573) 310-1855
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2018029780
MO
Other
Enumeration date
08/14/2018
Last updated
08/14/2018
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