Individual
VICKI STAFKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3296 RELAY RD, ORMOND BEACH, FL 32174-7911
(512) 297-9146
Mailing address
3296 RELAY RD, ORMOND BEACH, FL 32174-7911
(512) 297-9146
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 4289
FL
2255A2300X
Athletic Trainer
AT0914
TX
Other
Enumeration date
09/07/2015
Last updated
09/07/2015
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