Individual
MRS. LEAH M BRUECKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
401 CHAFFER AVE, ROXANA, IL 62084-1125
(618) 920-2452
Mailing address
312 CROSS CREEK DR, BETHALTO, IL 62010-2004
(618) 920-2452
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.001407
IL
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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