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Individual

CARRIE LEE ANDERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
567 N 5TH ST, TERRE HAUTE, IN 47809-1903
(217) 369-2216
Mailing address
12304 N 1900TH ST, MARSHALL, IL 62441-4805

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
096-002620
IL
2255A2300X
Athletic Trainer
Primary
36001697A
IN

Other

Enumeration date
10/30/2008
Last updated
01/13/2012
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