NPI 1093910812

Kelley Lucille Weidinger, ATCLAT

Practitioner Athletic Trainer Jefferson City, MO

Practice location

Address: 3308 W Edgewood Dr STE F, Jefferson City, MO 65109-6891
Phone: (573) 638-3400
Fax: (573) 638-3405
Mailing address: 11820 Maries Road 328, Vienna, MO 65582-7123

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 2007017252 (MO)

Other Specialist/Technologist providers in Missouri →

Registry record

NPI: 1093910812
Entity type: Individual
Sex (as registered): Female
NPI issued: 20 Jun 2007
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.