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Individual

MS. KARISSA DILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LAT, ATC

Contact information

Practice address
1905 CRESTMOOR COVE CC CT, NORMAL, IL 61761-5352
(815) 674-0814
Mailing address
1905 CRESTMOOR COVE CC CT, NORMAL, IL 61761-5352

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004339
IL

Other

Enumeration date
01/04/2018
Last updated
01/04/2018
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