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1336339324
ALLEN WAYNE MARDIS
CARBONDALE, IL
NPI
1336339324
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2007-07-26
Last Update Date
2013-11-07
Business Address
-- ALLEN WAYNE MARDIS ATC
1490 DOUGLAS DR MC 6620
CARBONDALE, IL 62901-4332
Phone number: 570-492-1784
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Mailing Address
-- ALLEN WAYNE MARDIS ATC
1490 DOUGLAS DR MC 6620
CARBONDALE, IL 62901-4332
Phone number: 570-492-1784
Copy
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