Individual
ANDILYNN LEIGH BEADLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
901 S NATIONAL AVE, SPRINGFIELD, MO 65897-0027
(620) 704-2188
Mailing address
901 S NATIONAL AVE, SPRINGFIELD, MO 65897-0027
(620) 704-2188
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2011018892
MO
Other
Enumeration date
08/03/2011
Last updated
08/03/2011
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