Individual
STEVEN BONTRAGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1512 KEMPER ST, SCOOBA, MS 39358-7601
(662) 476-5272
Mailing address
1512 KEMPER ST, SCOOBA, MS 39358-7601
(662) 476-5272
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0511
MS
Other
Enumeration date
09/07/2018
Last updated
09/07/2018
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