Individual
JEFFREY MICHAEL STOUDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
415 HARRISBURG AVENUE, LANCASTER, PA 17604
(717) 291-4111
Mailing address
20 HOBSON COURT, PO BOX 1006, BROWNSTOWN, PA 17508
(717) 291-4111
(717) 291-4308
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT001361A
PA
Other
Enumeration date
10/23/2006
Last updated
07/08/2007
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