Individual
BRIIAHNA KC STAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
32 CAMPUS DR, MISSOULA, MT 59801-4494
(406) 243-0211
Mailing address
1582 E 8850 S, SANDY, UT 84093-1565
(385) 235-2844
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/01/2024
Last updated
07/01/2024
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