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General NPI Number Information
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NPI Number | 1952002917
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Entity Type | Individual
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Provider Name | MARGARET ANNE RALL M.ED., ATC
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Gender | Female
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Dates
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Enumeration Date | 03/15/2023
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Last Update Date | 03/15/2023
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Provider Practice Location Address
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Address Line | 11333 BIG BEND RD
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City | SAINT LOUIS
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State | MO
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Zip | 63122-5799
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Country | US
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Telephone | 314-494-9276
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Fax | 314-584-2094
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Provider Business Mailing Address
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Address Line | 6303 SUTHERLAND AVE APT A
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City | SAINT LOUIS
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State | MO
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Zip | 63109-2220
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Country | US
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Telephone | 314-494-9276
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2005034035
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License Number State | MO
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