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Individual

MICHAEL STEVENSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1444 LAWNRIDGE ST, MEDFORD, OR 97504-6248
(541) 842-5301
Mailing address
1444 LAWNRIDGE ST, MEDFORD, OR 97504-6248
(541) 842-5301

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
04/17/2014
Last updated
04/17/2014
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