Individual
GRACE LAILA WOERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2200 BONFORTE BLVD, PUEBLO, CO 81001-4901
(907) 306-0466
Mailing address
4239 CHARING CROSS CIR, ANCHORAGE, AK 99504-4427
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/25/2017
Last updated
10/25/2017
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