Individual
LINDA PECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
509 HAMACHER ST, WATERLOO, IL 62298-1592
(618) 939-5555
Mailing address
2322 RUSSELL BLVD, SAINT LOUIS, MO 63104-2609
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003871
IL
2255A2300X
Athletic Trainer
2014020186
MO
Other
Enumeration date
02/17/2015
Last updated
02/17/2015
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