Individual
EMILY RIDENOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
833 LAKE SHORE DR, BRANSON, MO 65616-9466
(540) 419-1707
Mailing address
833 LAKE SHORE DR., BRANSON, MO 65616-9466
(540) 419-1707
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2014021754
MO
Other
Enumeration date
01/26/2015
Last updated
01/26/2015
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