GLEN DWAYNE GERDES

LIBERTYVILLE, IL
NPI1205993227
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL  096000786)
Enumeration Date2007-01-02
Last Update Date2007-07-08
Business Address
Mr. GLEN DWAYNE GERDES MS, ATC
801 S MILWAUKEE AVE
LIBERTYVILLE, IL 60048-3204
Phone number: 847-990-5779
Mailing Address
Mr. GLEN DWAYNE GERDES MS, ATC
630 TALLGRASS LN
LAKE VILLA, IL 60046-6632
Phone number: 847-265-4113
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