Individual
STEPHANIE HEISLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
426 REVONAH HILL RD, LIBERTY, NY 12754-3319
(845) 292-5210
Mailing address
426 REVONAH HILL RD, LIBERTY, NY 12754-3319
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/17/2016
Last updated
11/17/2016
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