Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
VIDAL LUIS MORA, L.A.T., A.T.C.
ActiveVIDAL LUIS MORA, L.A.T., A.T.C. is a Athletic Trainer healthcare provider located in LAKE SAINT LOUIS, Missouri. NPI 1841643780 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · LAKE SAINT LOUIS, MO
Registration Details
- NPI Number
- 1841643780
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 15, 2016 (10.044601731314 yrs)
- Last Updated
- Jul 15, 2016
- License
-
2015023352 (MO)
Practice Information
- Address
-
7140 WELSH DRLAKE SAINT LOUIS, MO, 633674870Browse MO providers · Browse ZIP 63367
- Phone
- 6362881928
- Primary Specialty
-
Athletic Trainer
2255A2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.