Individual
ELISSA MORALES-VILLANUEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, ATC
Contact information
Practice address
5620 SPRING CREEK RD, ROCKFORD, IL 61114-6442
(815) 654-4870
Mailing address
2005 GRENSHAW ST, ROCKFORD, IL 61101-4234
(815) 668-3544
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/14/2022
Last updated
10/04/2023
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