David Eaton Colt, ATC, LAT
Individual provider Active NPI Athletic Trainer · Maryville, MO
NPI 1124087069 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1124087069
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 00015 (MO)
- Practice address
- 800 University Dr
Lac - 043
Maryville, MO 64468-6015 - Phone
- (660) 562-1313
- NPI assigned
- Mar 20, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00015 | MO | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 00015 | MO | Yes |
Addresses
Primary practice location
800 University Dr
Lac - 043
Maryville, MO 64468-6015
Mailing address
1427 N Mulberry St
Maryville, MO 64468-1156
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- Erika Lee Clark
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All providers in Maryville, MO · Athletic Trainer in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.