| Evangel University | |
|
1111 N Glenstone Ave Ashcroft Building Springfield MO 65802-2125 | |
| (417) 865-2815 | |
| Not Available |
| Full Name | Evangel University |
|---|---|
| Speciality | Clinic/center |
| Location | 1111 N Glenstone Ave, Springfield, Missouri |
| Authorized Official Name and Position | Marisa Foltz (HEAD ATHLETIC TRAINER) |
| Authorized Official Contact | 4178652815 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evangel University 1111 N Glenstone Ave Springfield MO 65802-2125 Ph: (417) 865-2815 | Evangel University 1111 N Glenstone Ave Ashcroft Building Springfield MO 65802-2125 Ph: (417) 865-2815 |
| NPI Number | 1518310101 |
|---|---|
| Provider Enumeration Date | 07/19/2016 |
| Last Update Date | 07/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518310101 | NPI | - | NPPES |
| 1184022501 | Other | MO | ATC |
| 1659769768 | Other | MO | ATC |
| 1982055901 | Other | MO | ATC |
| 1700238615 | Other | MO | ATC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2014021703 (Missouri) | Primary |
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