Individual
HOSANNAH MARIE DALOGDOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
2225 W MARKET ST, BLOOMINGTON, IL 61705-5014
(309) 828-8626
Mailing address
2000 N LINDEN ST APT J305, NORMAL, IL 61761-5346
(312) 593-9945
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
051303186
IL
Other
Enumeration date
11/04/2020
Last updated
11/04/2020
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