Tim Woodstock, ATC
Specialist/Technologist, Athletic Trainer in Belleville, IL. Individual provider (NPI-1).
NPI number1043743545
StatusActive
Last updated in NPPESApr 11, 2017
Details
- NPI
- 1043743545
- Entity type
- Individual (NPI-1)
- Name
- Tim Woodstock
- Credential
- ATC
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Apr 11, 2017
- Last updated
- Apr 11, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 2015028487 | MO | Yes |
Practice location
2600 W Main StBelleville, IL 62226-6651
Phone 618-239-6386
Mailing address
8818 Ione LnSaint Louis, MO 63123-6422
Phone 636-667-7732
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All 29 Athletic Trainer providers in Belleville · All 1,953 providers in Belleville
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