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1336117795
EDWARD BRENT THOMPSON
CARBONDALE, IL
NPI
1336117795
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL 096-000016)
Enumeration Date
2006-03-10
Last Update Date
2007-07-08
Business Address
Mr. EDWARD BRENT THOMPSON ATC
INTERCOLLEGIATE ATHLETICS, SIU ARENA, RM. 118 SOUTHERN ILLINOIS UNIVERSITY
CARBONDALE, IL 62901-6620
Phone number: 618-453-5161
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Mailing Address
Mr. EDWARD BRENT THOMPSON ATC
1005 MEADOWLARK DR
CARTERVILLE, IL 62918-1619
Phone number: 618-985-2025
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