Individual
JASON HEINOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
810 W ANTHONY DR, URBANA, IL 61802-7431
(217) 383-6759
(217) 326-2368
Mailing address
311 S WILLIS AVE, CHAMPAIGN, IL 61821-3307
(217) 493-3291
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
01/04/2007
Last updated
07/08/2007
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