Individual
JOSHUA PARKER CRAIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
701 COLLEGE RD, LEBANON, IL 62254-1291
(907) 306-2196
Mailing address
128 SUGAR PINE LN, O FALLON, IL 62269-2536
(907) 306-2196
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096004336
IL
Other
Enumeration date
08/23/2017
Last updated
08/23/2017
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