IndividualActive
Leah Brueckner, ATC
NPI 1801504923 · Athletic Trainer · Roxana, IL
Provider details
- NPI number
- 1801504923
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- ATC
- Sex
- Female
- Sole proprietor
- No
- License
- 096.001407 (IL)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
401 Chaffer Ave
Roxana, IL 62084-1125
Phone: (618) 920-2452
Approximate (ZIP-level) locationGet directions
Mailing address
312 Cross Creek Dr
Bethalto, IL 62010-2004
Registry dates
- Enumerated
- 2022-11-08
- Last updated
- 2022-11-08
- Certified
- 2022-11-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.