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Individual

MISS ALEXANDRIA ROSWITA SAWYER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC

Contact information

Practice address
900 N JOHN R WOODEN DR, WEST LAFAYETTE, IN 47907-2117
(765) 494-1703
Mailing address
10525 S LONGWOOD DR, CHICAGO, IL 60643-2615

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003587
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
096003587
LICENSED ATHLETIC TRAINER
IL
Enumeration date
08/07/2017
Last updated
08/07/2017
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