Individual
MISS LAURA STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
4403 FAR HILLS AVE, KETTERING, OH 45429-2405
(937) 395-3920
Mailing address
4403 FAR HILLS AVE, KETTERING, OH 45429-2405
(937) 395-3920
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT001609
OH
Other
Enumeration date
02/28/2007
Last updated
01/29/2015
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