Individual
DANLA GAILEE J MAYBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
2206 E 32ND ST, JOPLIN, MO 64804-3007
(417) 347-3737
Mailing address
303 N SERGEANT AVE, JOPLIN, MO 64801-2764
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2013029402
MO
Other
Enumeration date
11/13/2013
Last updated
11/13/2013
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