Individual
ALLYSON ROSE VIEDERIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
30 N BRAINARD ST, NAPERVILLE, IL 60540-4607
(181) 597-9211
Mailing address
6759 CROWN RDG, ROCKFORD, IL 61103-8872
(181) 597-9211
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/26/2018
Last updated
08/26/2018
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