Individual
ALEXANDRIA ANNALICIA JAUREGUI-DUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2135 S FREMONT AVE, SPRINGFIELD, MO 65804-2239
(417) 820-8734
Mailing address
2135 S FREMONT AVE, SPRINGFIELD, MO 65804-2239
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2013021427
MO
Other
Enumeration date
07/22/2013
Last updated
07/22/2013
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