Individual
TOM GODAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
209 S KINGSHIGHWAY ST, SAINT CHARLES, MO 63301-1693
(636) 949-4628
Mailing address
209 S KINGSHIGHWAY ST, SAINT CHARLES, MO 63301-1693
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2002012299
MO
Other
Enumeration date
12/21/2016
Last updated
12/21/2016
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