Individual
MRS. ANN JEANETTE HARGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2122 N 27TH ST, DECATUR, IL 62526-2191
(217) 876-4971
Mailing address
620 E STELLA DR, DECATUR, IL 62526-1957
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.002802
IL
Other
Enumeration date
11/07/2013
Last updated
03/17/2018
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