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Jackson Brunner, LAT, ATC
NPI 1821563453 · on the registry since 2018
Practice
- Address
- 7160 Athletics Kaufman Football Building
Normal, IL 61790 - Phone
- (309) 438-0607
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-09-28
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois