Individual
CAITLIN KEROACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
110 HORTON FIELDHOUSE, CAMPUS BOX 7130, NORMAL, IL 61790-7130
(309) 438-3340
Mailing address
3008 CAMDEN CIR, WILLIAMSBURG, VA 23185-8713
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003548
IL
Other
Enumeration date
10/07/2014
Last updated
10/07/2014
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