Individual
RON DUBUQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
901 BLOSSOM LN, SAINT LOUIS, MO 63119-1213
(314) 968-4737
Mailing address
901 BLOSSOM LANE, ST LOUIS, MO 63119
(314) 968-4737
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
00017
MO
Other
Enumeration date
11/23/2007
Last updated
11/23/2007
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