Missouri State University Athletic Medical and Rehabilitation Services

NPI #1649341272 in Springfield, Missouri

Provider Information

NPI Number: 1649341272
Entity Type: Organization
Organization Name: Missouri State University Athletic Medical and Rehabilitation Services
Primary Specialty: Clinic/Center
Enumeration Date: Nov 13, 2006
Last Updated: Apr 1, 2010

Practice Location

Address: 901 S NATIONAL AVE
City: Springfield
State: Missouri
ZIP Code: 65897-0027
Phone: (417) 836-5461

Authorized Official

Name: MR. JAMES THOMAS PENKALSKI, ATC
Title: DIRECTOR
Phone: (417) 836-5461

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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