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1255397592
CRAIG W. DEVERELL
DECATUR, IL
NPI
1255397592
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL 096.000740)
Enumeration Date
2006-04-25
Last Update Date
2007-07-08
Business Address
Mr. CRAIG W. DEVERELL ATC, CSCS
1900 E LAKE SHORE DR SUITE 150
DECATUR, IL 62521-3824
Phone number: 217-428-6222
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Mailing Address
Mr. CRAIG W. DEVERELL ATC, CSCS
5452 N KRUSE RD
MT ZION, IL 62549-2723
Phone number: 217-433-0123
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