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General NPI Number Information
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NPI Number | 1518310101
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Entity Type | Organization
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Legal Business Name | EVANGEL UNIVERSITY
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 07/19/2016
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Provider Practice Location Address
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Address Line | 1111 N GLENSTONE AVE ASHCROFT BUILDING
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City | SPRINGFIELD
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State | MO
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Zip | 65802-2125
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Country | US
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Telephone | 417-865-2815
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Fax |
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Provider Business Mailing Address
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Address Line | 1111 N GLENSTONE AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65802-2125
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Country | US
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Telephone | 417-865-2815
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Fax |
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Authorized Official
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Title or Position | HEAD ATHLETIC TRAINER
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Name | MARISA FOLTZ
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Credential | ATC, LAT
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Telephone | 417-865-2815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2014021703
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License Number State | MO
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