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Individual

MS. KAREN DONNA STUART FALLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
2817 REILLY ST, FORT BRAGG, NC 28310-6723
(850) 590-1301
Mailing address
2840 COMPASS CT APT 308B, FORT BRAGG, NC 28307-2193
(850) 590-1301

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
24-01007
KS
2255A2300X
Athletic Trainer
Primary
AL5567
FL
2255A2300X
Athletic Trainer
LAT-3045
NC

Other

Enumeration date
03/22/2016
Last updated
08/16/2022
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