Individual
MR. JUSTIN M. STANEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
5120 CAMPUS, NORMAL, IL 61790-5120
(319) 269-8422
Mailing address
713 W COLLEGE AVE, NORMAL, IL 61761-2455
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
IL
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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