Individual
MR. WILLIAM THOMAS LANGSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED, ATC
Contact information
Practice address
1402 S 1ST ST, CHAMPAIGN, IL 61820-6916
(217) 244-7683
(217) 333-6460
Mailing address
1402 S 1ST ST, CHAMPAIGN, IL 61820-6916
(217) 244-7683
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004166
IL
Other
Enumeration date
10/18/2018
Last updated
10/18/2018
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