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1558800250
MARK MAMMEN
CHAMPAIGN, IL
NPI
1558800250
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2017-02-15
Last Update Date
2017-02-15
Business Address
-- MARK MAMMEN
1806 N MARKET ST
CHAMPAIGN, IL 61822-1312
Phone number: 217-356-4920
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Mailing Address
-- MARK MAMMEN
790 REMINGTON BLVD
BOLINGBROOK, IL 60440-4909
Phone number: 630-296-2223
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