Individual
JOHN E MASSIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
374 E. GRAND AVE., SIUC STUDENT HEALTH CENTER, CARBONDALE, IL 62901
(618) 453-1292
(618) 453-4290
Mailing address
374 E. GRAND AVE., SIUC STUDENT HEALTH CENTER, CARBONDALE, IL 62901
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
02/23/2007
Last updated
07/08/2007
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