Individual
BRANDON MUNDLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
131 WELLINGTON DR, TROY, MO 63379-2947
(573) 822-7331
Mailing address
131 WELLINGTON DR, TROY, MO 63379-2947
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2013029735
MO
Other
Enumeration date
04/21/2016
Last updated
04/21/2016
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