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Individual

KYLE JORDAN FRERKING

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAT, ATC

Contact information

Practice address
800 UNIVERSITY DR, MARYVILLE, MO 64468-6001
(816) 783-7179
Mailing address
116 N DEPOT ST, MARYVILLE, MO 64468-1948
(816) 783-7179

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
03/27/2023
Last updated
07/02/2024
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