Individual
MR. STEPHEN LEVI MOFFETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBA, LAT, ATC
Contact information
Practice address
5199 WOLF CREEK RD., SPRING CITY, TN 37381
(423) 785-6558
Mailing address
1200 CORPORATE DR STE 400, BIRMINGHAM, AL 35242-5424
(423) 238-8930
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0000002373
TN
2255A2300X
Athletic Trainer
AT003345
GA
Other
Enumeration date
08/01/2019
Last updated
08/02/2019
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