Individual
BRYNN HACKNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
600 S SMILEY ST, O FALLON, IL 62269-2316
(618) 632-3507
Mailing address
660 WILD HORSE CREEK DR, FAIRVIEW HEIGHTS, IL 62208-2049
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004050
IL
Other
Enumeration date
05/17/2018
Last updated
05/17/2018
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