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Individual

MORGAN ELIZABETH DEPLANTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC, LAT

Contact information

Practice address
215 N MAIN ST, NORMAL, IL 61761
(309) 438-8671
Mailing address
1170 E 625 N, MARSHALL, IN 47859-8885
(765) 592-2889

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004499
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
096004499
LICENSED ATHLETIC TRAINER
IL
Enumeration date
02/09/2019
Last updated
02/09/2019
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