Individual
ELIZABETH BACON STUDDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, ATC
Contact information
Practice address
1671 S COLONNADE DR APT 203, FAYETTEVILLE, AR 72701-7819
(205) 746-5362
Mailing address
1671 S COLONNADE DR APT 203, FAYETTEVILLE, AR 72701-7819
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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