Individual
JOHNNIE JO HUDGINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1600 UNIVERSITY AVE, BOLIVAR, MO 65613-2578
(417) 777-7763
Mailing address
1600 UNIVERSITY AVE, BOLIVAR, MO 65613-2578
(417) 777-7763
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2017020219
MO
Other
Enumeration date
05/12/2016
Last updated
03/17/2018
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