Individual
JOANNA ZIDICK MCCLAREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
639 N WADE ST, MEXICO, MO 65265-1822
(573) 581-4296
Mailing address
639 N WADE ST, MEXICO, MO 65265-1822
(573) 581-4296
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2002025637
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2002025637
MISSOURI STATE BOARD OF REGISTRATION FOR THE HEALING ARTS: ATHLETIC TRAINER
MO
Enumeration date
07/01/2019
Last updated
10/25/2022
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