Individual
MR. RODNEY DEAN FORD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4550 MEMORIAL DR. OFFICE CENTER ONE STE G100, BELLEVILLE, IL 62226-5372
(618) 236-2246
(618) 236-2315
Mailing address
4550 MEMORIAL DR. OFFICE CENTER ONE STE G100, BELLEVILLE, IL 62226-5372
(618) 236-2246
(618) 236-2315
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.001223
IL
2255A2300X
Athletic Trainer
2000164612
MO
Other
Enumeration date
06/20/2011
Last updated
06/20/2011
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