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Individual

ELIZABETH BREEDLOVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
140 W MAIN ST, SOUTH VIENNA, OH 45369-3502
(434) 660-8702
Mailing address
760 S XENIA DR APT B, ENON, OH 45323-1763

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
OH
2255A2300X
Athletic Trainer
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
10/04/2023
Last updated
04/24/2026
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