Individual
MRS. STACY KATHLENA WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT, ATC
Contact information
Practice address
3106 REID RD, SWARTZ CREEK, MI 48473-8813
(810) 845-0005
Mailing address
3106 REID RD, SWARTZ CREEK, MI 48473-8813
(810) 845-0005
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
L534315
MI
Other
Enumeration date
04/04/2017
Last updated
04/04/2017
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