Individual
MS. CARSON MOESLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070024015
IL
2255A2300X
Athletic Trainer
M24011592870
IL
Other
Enumeration date
01/04/2016
Last updated
09/25/2018
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