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Individual

MOLLY LYNN ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1 UNIVERSITY CIR, WESTERN ILLINOIS UNIVERSITY, MACOMB, IL 61455-1367
(309) 298-2135
Mailing address
630 S JOHNSON ST, MACOMB, IL 61455-2843
(217) 316-6794

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
IL

Other

Enumeration date
04/10/2007
Last updated
07/08/2007
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