Individual
BRENDA LOU MUTERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT ATC
Contact information
Practice address
3545 S NATIONAL AVE, SPRINGFIELD, MO 65807-7310
(417) 269-5530
Mailing address
879 E BARRACUDA DR, NIXA, MO 65714-9158
(816) 309-8259
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2015023436
MO
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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