Individual
SUSAN MARY STODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
250 E BROADWAY, REARDAN, WA 99029-8693
(509) 215-0146
(509) 796-3291
Mailing address
250 E BROADWAY, REARDAN, WA 99029-8693
(509) 215-0146
(509) 796-3291
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA60242216
WA
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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