Edward R Wilkerson, LAT, ATC
Specialist/Technologist, Athletic Trainer in Columbia, MO. Individual provider (NPI-1).
NPI number1982138038
StatusActive
Last updated in NPPESApr 15, 2017
Details
- NPI
- 1982138038
- Entity type
- Individual (NPI-1)
- Name
- Edward R Wilkerson
- Credential
- LAT, ATC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 15, 2017
- Last updated
- Apr 15, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 2005038358 | MO | Yes |
Practice location
1200 E BroadwayColumbia, MO 65215-1000
Phone 573-441-5175
Mailing address
1200 E BroadwayColumbia, MO 65215-1000
Phone 573-441-5175
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