Individual
STACIA HALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
605 DICKERSON DR, WINNEBAGO, IL 61088-8336
(815) 243-0837
Mailing address
605 DICKERSON DR, WINNEBAGO, IL 61088-8336
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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