Individual
RYAN NOVATNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, LAT, ATC
Contact information
Practice address
501 WESTMINSTER AVE, FULTON, MO 65251-1299
(573) 592-5623
Mailing address
501 WESTMINSTER AVE, FULTON, MO 65251-1230
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2018019009
MO
Other
Enumeration date
08/01/2018
Last updated
11/04/2020
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