Individual
KELLEY CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
901 S NATIONAL AVE, SPRINGFIELD, MO 65897-3100
(417) 836-5000
Mailing address
6150 CLAYTON HUSKEY RD, HILLSBORO, MO 63050-1312
(314) 650-7022
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
KY
2255A2300X
Athletic Trainer
Primary
—
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
KY
Other
Enumeration date
01/29/2019
Last updated
06/08/2020
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