Individual
MISS MICHELLE DIANE DEBOER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
350 N ILLINOIS AVE, MORTON, IL 61550-2206
(390) 266-7182
Mailing address
400 E TAZEWELL ST, TREMONT, IL 61568-8523
(309) 925-5405
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
06/27/2006
Last updated
07/08/2007
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