Individual
MICHAEL MCPEAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1836 S MACARTHUR BLVD, SPRINGFIELD, IL 62704-4030
(217) 546-0512
(217) 528-9854
Mailing address
3510 FERRIS DR, DECATUR, IL 62521-9164
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.005058
IL
Other
Enumeration date
10/17/2019
Last updated
10/17/2019
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