Individual
SARA E LOCICERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
2805 E 10TH ST, BLOOMINGTON, IN 47408-2698
(812) 855-3114
Mailing address
659 S CEDAR AVE, ELMHURST, IL 60126-4608
(630) 567-9159
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36001841A
IN
Other
Enumeration date
02/28/2012
Last updated
02/28/2012
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