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1649492539
SAMANTHA L WELTER
NORMAL, IL
NPI
1649492539
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL 096.002311)
Enumeration Date
2007-05-02
Last Update Date
2007-07-08
Business Address
Ms. SAMANTHA L WELTER ATC
110 HORTON FIELDHOUSE
NORMAL, IL 61790-7130
Phone number: 309-438-3340
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Mailing Address
Ms. SAMANTHA L WELTER ATC
19 TRADERS CIRCLE 257
NORMAL, IL 61761
Phone number:
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