MASON T COTTEREL

EDWARDSVILLE, IL
NPI1467108654
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2022-02-25
Last Update Date2022-11-03
Business Address
MASON T COTTEREL MAT, ATC
SOUTHERN ILLINOIS UNIVERSITY EDWARDSVILLE VC 2201
EDWARDSVILLE, IL 62026-3043
Phone number: 408-477-0953
Mailing Address
MASON T COTTEREL MAT, ATC
6800 WYDOWN BLVD
SAINT LOUIS, MO 63105-3043
Phone number: 408-477-0953