IndividualActive
Allen Mardis, ATC
NPI 1336339324 · Athletic Trainer · Carbondale, IL
Provider details
- NPI number
- 1336339324
- Entity type
- Individual
- Primary specialty
- Athletic TrainerRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1490 Douglas Dr
Mc 6620
Carbondale, IL 62901-4332
Phone: (570) 492-1784
Fax: (618) 453-4173
Approximate (ZIP-level) locationGet directions
Mailing address
1490 Douglas Dr
Carbondale, IL 62901-4332
Registry dates
- Enumerated
- 2007-07-26
- Last updated
- 2013-11-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.