Individual
STACY HATSUMI MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1919 SPANOS CT, SACRAMENTO, CA 95825-3981
(916) 568-3041
Mailing address
12147 BLAKE RD, WILTON, CA 95693-8534
(916) 996-8861
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/18/2019
Last updated
07/18/2019
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