Individual
TAYLOR RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
220 W LAKEWOOD ST, APT 206A, SPRINGFIELD, MO 65810-1867
(417) 988-4022
Mailing address
220 W LAKEWOOD ST, APT 206A, SPRINGFIELD, MO 65810-1867
(417) 988-4022
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/02/2014
Last updated
09/02/2014
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