Individual
DR. MYRA ANN STOCKDALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DHSC, ATC, LAT
Contact information
Practice address
2001 NEWBURG RD, LOUISVILLE, KY 40205-1863
(502) 272-7614
Mailing address
231 E GRUNDY AVE, SPRINGFIELD, KY 40069-1114
(812) 599-1263
(502) 272-7614
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
36000285A
IN
2255A2300X
Athletic Trainer
Primary
AT1347
KY
Other
Enumeration date
02/17/2006
Last updated
04/09/2017
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