Individual
STEPHANIE NICOLE FORTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
1700 FULTON ST E, GRAND RAPIDS, MI 49506-1799
(616) 632-2971
Mailing address
500 FULTON ST E APT 375, GRAND RAPIDS, MI 49503-4400
(616) 460-2385
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001186
MI
Other
Enumeration date
05/14/2019
Last updated
05/14/2019
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