MICHAEL PATRICK PENDERGAST

MACOMB, IL
NPI1275598161
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL  096-000098)
Enumeration Date2006-04-20
Last Update Date2007-07-08
Business Address
-- MICHAEL PATRICK PENDERGAST ATC
WESTERN ILLINOS UNIVERSITY ATHLETIC DEPT. ONE UNIV. CIRCLE
MACOMB, IL 61455
Phone number: 309-208-1253
Mailing Address
-- MICHAEL PATRICK PENDERGAST ATC
340 W PIERCE ST
MACOMB, IL 61455-1443
Phone number: 309-833-5316
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