Individual
MISS DANA BARENTS HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, OPA-C
Contact information
Practice address
1715 BRADFORD LN, #140, NORMAL, IL 61761-5283
(309) 275-3802
Mailing address
1715 BRADFORD LN, #140, NORMAL, IL 61761-5283
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096003796
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1018849
NATA CERTIFICATION NUMBER
—
01
—
110754
BOARD OF CERTIFICATION ATC
—
Enumeration date
11/18/2014
Last updated
11/18/2014
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