Individual
JESSE LEE HERRINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AT
Contact information
Practice address
MISSOURI STATE UNIVERSITY ATHLETIC TRAINING SERVICES, 901 S. NATIONAL, SPRINGFIELD, MO 65897-0001
(417) 836-5461
(417) 836-6101
Mailing address
MISSOURI STATE UNIVERSITY ATHLETIC TRAINING SERVICES, 901 S. NATIONAL, SPRINGFIELD, MO 65897-0001
(417) 836-5461
(417) 836-6101
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2006022370
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2006022370
MO LICENSURE
MO
Enumeration date
08/03/2006
Last updated
07/08/2007
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