Individual
DANE MICHAEL LANGELLIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
306 MARION ST., MARTINTON, IL 60951-0134
(815) 383-5416
Mailing address
PO BOX 134, MARTINTON, IL 60951-0134
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003358
IL
Other
Enumeration date
08/31/2012
Last updated
08/31/2012
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