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Individual

MR. GARY L HAZELRIGG

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
802 N RIVERSIDE RD, SAINT JOSEPH, MO 64507-9794
(816) 271-4953
Mailing address
2817 LOVERS LN, SAINT JOSEPH, MO 64506-1523
(816) 364-5803
(816) 279-7574

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
00032
MO

Other

Enumeration date
06/17/2006
Last updated
07/08/2007
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