Individual
MR. MARCO S BOSCOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
10 DOCTORS PARK, GIBSON CITY, IL 60936-2009
(217) 784-2650
Mailing address
1508 E FLORIDA AVE, APT. A, URBANA, IL 61802-4683
(217) 239-7585
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
03/07/2007
Last updated
07/09/2007
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