Individual
MISS COURTNEY LEANNE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
319 BROWN AVE, ROCKFORD, IL 61103-4102
(815) 670-2803
Mailing address
319 BROWN AVE, ROCKFORD, IL 61103-4102
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/16/2017
Last updated
07/16/2017
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