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Individual
MORGAN MELQUIST
Active
Individual
MORGAN MELQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096005627
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000000000
N/A
—
01
—
096005627
IDFPR STATE LICENSURE FOR ATHLETIC TRAINERS
IL
01
—
2000035346
ATHLETIC TRAINING BOARD OF CERTIFICATION (BOC)
—
Enumeration date
10/31/2018
Last updated
03/22/2023
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