Individual
JACOB GLENN PARISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3631 S 6TH ST, SPRINGFIELD, IL 62703-4777
(217) 744-7529
Mailing address
7809 HUNT RD, SPRINGFIELD, IL 62712-8603
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/03/2018
Last updated
07/03/2018
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