Individual
MRS. JACQUELINE RENEE RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, ATC
Contact information
Practice address
8185 N HICKORY DR, COLUMBIA, MO 65202-7238
(573) 268-1898
Mailing address
8185 N HICKORY DR, COLUMBIA, MO 65202-7238
(573) 268-1898
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
MO
Other
Enumeration date
01/26/2017
Last updated
01/26/2017
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