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1245636646
SARAH NIEDZWIECKI
BELLEVILLE, IL
NPI
1245636646
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL 096.003836)
Enumeration Date
2014-11-12
Last Update Date
2015-06-09
Business Address
-- SARAH NIEDZWIECKI ATC
2600 W MAIN ST
BELLEVILLE, IL 62226-6651
Phone number: 618-239-6109
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Mailing Address
-- SARAH NIEDZWIECKI ATC
5819 BRETT MICHAEL LN APARTMENT 11
BELLEVILLE, IL 62223-3966
Phone number:
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