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1356313225
JOHN RICHARD STORSVED
DECATUR, IL
NPI
1356313225
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL 096-000920)
Enumeration Date
2006-02-06
Last Update Date
2019-06-21
Business Address
JOHN RICHARD STORSVED H.S.D. ATC
1184 W MAIN ST
DECATUR, IL 62522-2084
Phone number: 217-424-6364
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Mailing Address
JOHN RICHARD STORSVED H.S.D. ATC
2608 S NOTTINGHAM CT
CHAMPAIGN, IL 61821-7015
Phone number: 176-218-7972
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