Individual
JOHN RICHARD STORSVED II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
H.S.D. ATC
Contact information
Practice address
1184 W MAIN ST, DECATUR, IL 62522-2084
(217) 424-6364
Mailing address
2608 S NOTTINGHAM CT, CHAMPAIGN, IL 61821-7015
(176) 218-7972
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096-000920
IL
Other
Enumeration date
02/06/2006
Last updated
06/21/2019
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