Individual
JOE MATTINGLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2615 HARRISON ST, BELLWOOD, IL 60104-2450
(708) 493-0299
Mailing address
409 MILLWOOD DR, BARTLETT, IL 60103-5131
(630) 464-5778
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003562
IL
Other
Enumeration date
08/07/2013
Last updated
08/07/2013
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