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Individual

CHARLES MARSHALL STODDARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC, LAT

Contact information

Practice address
9256 S STATE ST, SANDY, UT 84070-2604
(801) 675-9813
Mailing address
9256 S STATE ST, SANDY, UT 84070-2604

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
9265541-4810
UT

Other

Enumeration date
02/05/2015
Last updated
02/05/2015
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