Individual
TAYLOR JEANETTE ROSECRANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
468 N KEN GRAY PKWY, INA, IL 62846-2408
(618) 437-5321
Mailing address
468 N KEN GRAY PKWY, INA, IL 62846-2408
(618) 437-5321
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004375
IL
Other
Enumeration date
11/11/2016
Last updated
12/23/2021
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