Individual
CHASE HARRISON LOUTHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
407 N CONDIT ST, TOLONO, IL 61880-9014
(217) 254-7283
Mailing address
407 N CONDIT ST, TOLONO, IL 61880-9014
(217) 254-7283
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004591
IL
Other
Enumeration date
01/24/2023
Last updated
01/24/2023
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