Individual
TRAVIS RAYMOND-CHARLIE STONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1716 MULBERRY AVE, UPLAND, CA 91784-1844
(909) 503-6004
Mailing address
1716 MULBERRY AVE, UPLAND, CA 91784
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000029583
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000029583
BOARD OF CERTIFICATION
—
Enumeration date
08/31/2017
Last updated
08/31/2017
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