Emma Marie Whisker

Individual provider Active NPI Athletic Trainer · Gridley, IL

NPI 1639718570 · NPPES record last updated Dec 23, 2019

Key facts

NPI
1639718570
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
105 Boulder Dr
Gridley, IL 61744-9271
Phone
(309) 310-2278
NPI assigned
Dec 23, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X Yes

Addresses

Primary practice location

105 Boulder Dr
Gridley, IL 61744-9271

Mailing address

105 Boulder Dr
Gridley, IL 61744-9271
Phone (309) 310-2278

Other providers in Gridley, IL

All providers in Gridley, IL · Athletic Trainer in Illinois

Sources for this page

Verify at the official NPI Registry.