Individual
STEPHANIE DENISE SULEWSKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCMA
Contact information
Practice address
1063 USS TENNESSEE AVE, AVENUE QL 11, KINGS BAY, GA 31547-2606
(210) 651-0027
Mailing address
1025 MAD FOX DR, JACKSONVILLE, FL 32212-1124
(843) 441-7408
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
616377
TX
Other
Enumeration date
12/29/2010
Last updated
12/29/2010
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