Individual
BRANDON MICHAEL MACTRINDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
827 S KINGS AVE, SPRINGFIELD, MO 65897-6565
(417) 836-5000
Mailing address
9700 RAVINIA CT APT 1E, ORLAND PARK, IL 60462-6565
(708) 466-1511
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2022028785
MO
2255A2300X
Athletic Trainer
—
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Enumeration date
10/14/2021
Last updated
07/29/2022
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