Individual
KEVIN MOEHN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
622 W CLARK ST APT 3, CHAMPAIGN, IL 61820-4665
(319) 750-4134
Mailing address
622 W CLARK ST APT 3, CHAMPAIGN, IL 61820-4665
(319) 750-4134
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
12/10/2014
Last updated
12/10/2014
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