Individual
KATIE STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC/L
Contact information
Practice address
3200 E SHAWNEE RD, MUSKOGEE, OK 74403-1861
(918) 684-3750
Mailing address
3200 E SHAWNEE RD, MUSKOGEE, OK 74403-1861
(918) 684-3750
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
921
OK
Other
Enumeration date
03/30/2016
Last updated
03/30/2016
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