Individual
MRS. JENNIFER RAISBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1251 TURTLE CREEK DR, O FALLON, MO 63366-5948
(314) 494-4320
Mailing address
9331 PHOENIX VILLAGE PKWY, O FALLON, MO 63368-4281
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2008002454
MO
Other
Enumeration date
10/01/2014
Last updated
10/01/2014
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