Evan Canton Hall
Individual provider Active NPI Athletic Trainer · Oak Grove, MO
NPI 1952117145 · NPPES record last updated Dec 4, 2024
Key facts
- NPI
- 1952117145
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 807 SW 15TH St
Oak Grove, MO 64075-7039 - Phone
- (816) 463-1954
- NPI assigned
- Dec 4, 2024
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
807 SW 15TH St
Oak Grove, MO 64075-7039
Mailing address
807 SW 15TH St
Oak Grove, MO 64075-7039
Phone (816) 463-1954
Other providers in Oak Grove, MO
- Brooke Ann Flaspohler
- Kristyn R Frazee
- Jody L Grasher
- Great Plains Chiropractic and Wellness L.L.C.
- Hannah Shae Haedike-Swift
- John Thomas Haller
- Shane Landon Hatfield
- Susan Y Hausheer
- Arezo Hesaraki
- Lisa K Hudson
All providers in Oak Grove, 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 Dec 4, 2024. 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.