Individual
JOHN WILLIAM EDGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
703 E US HIGHWAY 40, TROY, IL 62294-2210
(618) 667-8851
Mailing address
327 BENEDICTINE CT, O FALLON, IL 62269-3580
(618) 910-0139
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096001024
IL
Other
Enumeration date
08/13/2024
Last updated
08/13/2024
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