Allen Wayne Mardis, ATC
NPI #1336339324 in Carbondale, Illinois
Provider Information
- NPI Number
- 1336339324
- Entity Type
- Individual
- Name
- Allen Wayne Mardis, ATC
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC
- Enumeration Date
- Jul 26, 2007
- Last Updated
- Nov 7, 2013
Practice Location
- Address
- 1490 DOUGLAS DR
- Address 2
- MC 6620
- City
- Carbondale
- State
- Illinois
- ZIP Code
- 62901-4332
- Phone
- (570) 492-1784
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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