Individual
TANNA COSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1427 EAST AVE, BELVIDERE, IL 61008-4560
(815) 668-5073
Mailing address
1427 EAST AVE, BELVIDERE, IL 61008-4560
(815) 668-5073
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/25/2019
Last updated
01/25/2019
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