ALLEN WAYNE MARDIS

CARBONDALE, IL
NPI1336339324
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date2007-07-26
Last Update Date2013-11-07
Business Address
-- ALLEN WAYNE MARDIS ATC
1490 DOUGLAS DR MC 6620
CARBONDALE, IL 62901-4332
Phone number: 570-492-1784
Mailing Address
-- ALLEN WAYNE MARDIS ATC
1490 DOUGLAS DR MC 6620
CARBONDALE, IL 62901-4332
Phone number: 570-492-1784