Individual
PAMELA STASO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4430 MISSOURI AVE, FORT LEONARD WOOD, MO 65473
(573) 596-0035
Mailing address
23732 RISEN RD, WAYNESVILLE, MO 65583-2506
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RTO000159
PA
Other
Enumeration date
03/15/2016
Last updated
02/13/2019
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