David Henry Anderson
Specialist/Technologist, Athletic Trainer in Saint Louis, MO. Individual provider (NPI-1).
NPI number1093339590
StatusActive
Last updated in NPPESJun 1, 2020
Details
- NPI
- 1093339590
- Entity type
- Individual (NPI-1)
- Name
- David Henry Anderson
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 1, 2020
- Certification date
- Jun 1, 2020
- Last updated
- Jun 1, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 2015038420 | MO | Yes |
Practice location
6643 Shepley DrSaint Louis, MO 63105-2354
Phone 314-935-6677
Mailing address
6209 Tholozan AveSaint Louis, MO 63109-1367
Phone 314-435-9713
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