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Individual

HALEY NYSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
951 ESSINGTON RD, JOLIET, IL 60435-8439
(708) 638-6504
Mailing address
347 HILLSIDE RD, NEW LENOX, IL 60451-1619
(708) 638-6504

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004687
IL
2255A2300X
Athletic Trainer
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
09/13/2017
Last updated
09/28/2022
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