Individual
NATHAN CHARLES KESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
FORSYTHE ATHLETICS CTR, 901 SOUTH NATIONAL STREET, SPRINGFIELD, MO 65897-0001
(417) 836-4715
Mailing address
4725 S GLENN AVE, SPRINGFIELD, MO 65810-1242
(417) 848-3274
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2008026071
MO
Other
Enumeration date
09/10/2008
Last updated
09/10/2008
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