Individual
KAYLA NICOLE RODEBAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1010 FAIRWAY DRIVE, FREEPORT, IL 61032
(815) 599-6000
Mailing address
1045 W STEPHENSON ST, PO BOX 857, FREEPORT, IL 61032-4864
(815) 599-6000
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096002486
IL
Other
Enumeration date
02/19/2009
Last updated
02/19/2009
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