Individual
SYDNEY DIEKHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
701 COLLEGE RD, LEBANON, IL 62254-1291
(618) 537-6929
Mailing address
253 RIVER LAUREL DR, BELLEVILLE, IL 62220-3291
(309) 620-0380
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096005653
IL
Other
Enumeration date
09/11/2024
Last updated
09/11/2024
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