CLAYTON A. CORLESS

ROCKFORD, IL
NPI1932172087
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL  0096-000784)
Enumeration Date2006-02-09
Last Update Date2007-07-08
Business Address
-- CLAYTON A. CORLESS ATC
5510 E STATE ST
ROCKFORD, IL 61108-2381
Phone number: 815-395-4505
Mailing Address
-- CLAYTON A. CORLESS ATC
474 W EXCHANGE ST
SYCAMORE, IL 60178-1307
Phone number: