Individual
LANELLE EMERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
7321 BALMER ST, HILL AFB, UT 84056-5012
(801) 775-2529
Mailing address
2833 N 200 W, NORTH OGDEN, UT 84414-2200
(910) 333-4003
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
12369690-4810
UT
Other
Enumeration date
10/06/2014
Last updated
10/05/2021
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