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1932257110
STACIE NICHOLE WOODWORTH
SYCAMORE, IL
NPI
1932257110
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL 96001400)
Enumeration Date
2007-01-06
Last Update Date
2015-12-29
Business Address
Mrs. STACIE NICHOLE WOODWORTH ATC
2128 MIDLANDS CT
SYCAMORE, IL 60178-3199
Phone number: 815-758-0000
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Mailing Address
Mrs. STACIE NICHOLE WOODWORTH ATC
315 W CHESTER DR
MAPLE PARK, IL 60151-9193
Phone number: 630-707-7556
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