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Individual

MS. AMY KULCZYCKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC, CSCS

Contact information

Practice address
200 S SHELDON ST, RANTOUL, IL 61866-2431
(217) 892-2151
Mailing address
1176 POMONA DR, CHAMPAIGN, IL 61822-1857
(217) 390-4877

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
07/18/2006
Last updated
07/08/2007
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