Individual
HANNAH LYN MIDLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2001 ALFORD PARK DR, KENOSHA, WI 53140-1994
(262) 551-6104
Mailing address
8000 HUMMINGBIRD CIR, JOLIET, IL 60431-4011
(815) 641-9958
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/01/2020
Last updated
03/01/2020
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