Individual
ELISE PACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
739 WESTMORE RD, DAVIS, IL 61019-9552
(815) 494-2385
Mailing address
739 WESTMORE RD, DAVIS, IL 61019-9552
(815) 494-2385
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
MO
Other
Enumeration date
01/28/2022
Last updated
01/28/2022
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