Individual
STEPHANIE MICHELLE VANDER VELDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MHR, ATC
Contact information
Practice address
151 ADAMS LN STE 11, MT JULIET, TN 37122-8320
(615) 773-1561
(615) 773-1564
Mailing address
4261 CHESNEY GLEN DR, HERMITAGE, TN 37076-4431
(615) 584-4161
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0000000791
TN
Other
Enumeration date
09/01/2006
Last updated
07/08/2007
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