Individual
STEPHANIE E BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
950 W WOOSTER ST, BOWLING GREEN, OH 43402-2603
(419) 354-8900
Mailing address
432 BUTTONWOOD AVE, BOWLING GREEN, OH 43402-3715
(419) 807-8344
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT2254
OH
Other
Enumeration date
01/17/2007
Last updated
07/08/2007
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