Tim Woodstock, ATC

NPI 1043743545 · on the registry since 2017 · sole proprietor

Practice

Address: 2600 W Main St
Belleville, IL 62226
Phone: (618) 239-6386
Organisation at this address: Lindenwood University-Belleville
Belleville Township High School District 201
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 17

Registry record

Primary taxonomy: Athletic Trainer
2255A2300X
Licence states on file: MO
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2017-04-11

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