Individual
STACIE BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1201 HEROLD AVE, DES MOINES, IA 50315
(515) 778-3439
Mailing address
1201 HEROLD AVE, DES MOINES, IA 50315-3858
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
082504
IA
Other
Enumeration date
11/17/2016
Last updated
11/17/2016
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