Jason Clifford Halverson MA, ATC, CSCS

NPI 1396954004 - Specialist/Technologist - 2255A2300X

NPI Details
NPI 1396954004
Gender Male
Enumeration Date 05/21/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
1600 UNIVERSITY AVE
BOLIVAR MO, 65613-2578, US
Phone (417) 328-2070
Fax
Business Location
1305 S VILLAGE LN
BOLIVAR MO, 65613-2793, US
Phone (417) 326-4587
Fax
Toxanomy
Taxonomy Code 2255A2300X
License State Missouri
License Number 2004001637
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According to our database, Mr. Jason Clifford Halverson MA, ATC, CSCS NPI is 1396954004, taxonomy code is 2255A2300X and license number is 2004001637, license state is located at Missouri. Jason Clifford Halverson MA, ATC, CSCS physically located at 1600 University Ave, Bolivar MO, 65613-2578. NPI Number Jason Clifford Halverson MA, ATC, CSCS has the Individual type.

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1396954004 NPI number is provided on an as is basis without warranty of any kind. 1396954004 is maintained by the National Plan & Provider Enumeration System. The contents of Jason Clifford Halverson MA, ATC, CSCS are for informational purposes only.