Individual
GREGORY LEE GAA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
7800 N SOMMER ST STE 608, PEORIA, IL 61615-1968
(303) 676-5546
Mailing address
303 N WILLIAM KUMPF BLVD, PEORIA, IL 61605-2507
(306) 676-5545
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.000291
IL
Other
Enumeration date
03/03/2018
Last updated
03/17/2018
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