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1083100994
JACOB GLENN PARISH
SPRINGFIELD, IL
NPI
1083100994
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2018-07-03
Last Update Date
2018-07-03
Business Address
JACOB GLENN PARISH ATC
3631 S 6TH ST
SPRINGFIELD, IL 62703-4777
Phone number: 217-744-7529
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Mailing Address
JACOB GLENN PARISH ATC
7809 HUNT RD
SPRINGFIELD, IL 62712-8603
Phone number:
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