Individual
AVERY NICOLE RUNYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1513 QUEENS RD, KIRKSVILLE, MO 63501-2738
(317) 443-4548
Mailing address
1513 QUEENS RD, KIRKSVILLE, MO 63501-2738
(317) 443-4548
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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