TIM WOODSTOCK

BELLEVILLE, IL
NPI1043743545
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MO  2015028487)
Enumeration Date2017-04-11
Last Update Date2017-04-11
Business Address
-- TIM WOODSTOCK ATC
2600 W MAIN ST
BELLEVILLE, IL 62226-6651
Phone number: 618-239-6386
Mailing Address
-- TIM WOODSTOCK ATC
8818 IONE LN
SAINT LOUIS, MO 63123-6422
Phone number: 636-667-7732
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