Individual
SAMUEL JOSEPH STUKENBORG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5900 WALNUT GROVE RD, MEMPHIS, TN 38120-2104
(901) 264-4900
Mailing address
5900 WALNUT GROVE RD, MEMPHIS, TN 38120-2104
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2298
TN
Other
Enumeration date
12/13/2017
Last updated
12/13/2017
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