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Individual

MRS. FAYE DENISE HUDSON

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
A.T.,C

Contact information

Practice address
4331 S FREMONT AVE, SPRINGFIELD, MO 65804-7328
(471) 820-5010
(417) 820-5022
Mailing address
281 E KATIE DR, SPRINGFIELD, MO 65803-4577
(417) 833-1879

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2005038356
MO

Other

Enumeration date
02/14/2006
Last updated
07/08/2007
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