Individual
MICHELLE CROCKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1 COLLEGE PARK DR, SAINT LOUIS, MO 63141-8660
(314) 485-8415
Mailing address
7147 HIGHWAY 47, UNION, MO 63084-2478
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2011018209
MO
Other
Enumeration date
12/06/2011
Last updated
12/06/2011
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