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1295193902
PETER MAINVILLE
CHICAGO, IL
NPI
1295193902
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL 096003512)
Enumeration Date
2016-02-09
Last Update Date
2016-02-09
Business Address
-- PETER MAINVILLE ATC
1060 W ADDISON ST
CHICAGO, IL 60613-4566
Phone number: 773-404-4222
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Mailing Address
-- PETER MAINVILLE ATC
1408 W PLYMOUTH DR
ARLINGTON HEIGHTS, IL 60004-2845
Phone number: 224-735-2183
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