Individual
HALEY LANDEWEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
900 E WALNUT ST STE 1, CARBONDALE, IL 62901-3132
(618) 319-7542
Mailing address
404 CEDAR RD, MURPHYSBORO, IL 62966-4413
(618) 559-0889
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004753
IL
2255A2300X
Athletic Trainer
2019015073
MO
Other
Enumeration date
01/18/2023
Last updated
01/18/2023
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