Individual
MRS. LAURA MARIE MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1 UNIVERSITY PKWY, ROMEOVILLE, IL 60446-2200
(555) 555-5555
Mailing address
1 UNIVERSITY PKWY, ROMEOVILLE, IL 60446-2200
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003054
IL
Other
Enumeration date
02/14/2007
Last updated
04/02/2016
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