Individual
GABRIELLE HEROD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5270 SPRINGTRAIL DR, BLACK JACK, MO 63033-4417
(314) 412-0545
Mailing address
5270 SPRINGTRAIL DR, BLACK JACK, MO 63033-4417
(314) 412-0545
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/14/2021
Last updated
04/14/2021
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