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1811181969
NATHANIEL BO ANDERSON
CHICAGO, IL
NPI
1811181969
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL 096-002493)
Enumeration Date
2007-08-31
Last Update Date
2007-08-31
Business Address
-- NATHANIEL BO ANDERSON ATC
6560 W FULLERTON AVE
CHICAGO, IL 60707-3439
Phone number: 773-745-0338
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Mailing Address
-- NATHANIEL BO ANDERSON ATC
5047 N CENTRAL PARK AVE APT 2B
CHICAGO, IL 60625-5540
Phone number:
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