Individual
ABBEY COLCLASURE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2101 CUMBERLAND AVE APT 11207, WEST LAFAYETTE, IN 47906-4076
(630) 888-4259
Mailing address
2101 CUMBERLAND AVE APT 11207, WEST LAFAYETTE, IN 47906-4076
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003077A
IN
Other
Enumeration date
09/26/2018
Last updated
09/26/2018
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