Individual
ERICA HEDGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.T.C
Contact information
Practice address
1397 BRISTOL LN, BUFFALO GROVE, IL 60089-1259
(616) 566-2635
Mailing address
1397 BRISTOL LN, BUFFALO GROVE, IL 60089-1259
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
PROVIDER CODE 22 (RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS)
—
Enumeration date
10/27/2011
Last updated
10/27/2011
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