Individual
BRETT ANDREW SUTPHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC, LAT
Contact information
Practice address
50 BLACKWOOD DR, MURPHYSBORO, IL 62966-2937
(618) 687-2336
Mailing address
50 BLACKWOOD DR, MURPHYSBORO, IL 62966-2937
(618) 687-2336
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096000916
IL
Other
Enumeration date
12/17/2017
Last updated
12/17/2017
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