Individual
MR. PETER MARTIN STOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, EMT-B
Contact information
Practice address
3631 S 6TH ST, SUITE B, SPRINGFIELD, IL 62703-4777
(217) 744-7529
(217) 529-0988
Mailing address
3631 S 6TH ST, SUITE B, SPRINGFIELD, IL 62703-4777
(217) 744-7529
(217) 529-0988
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.000201
IL
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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