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Individual

MS. STEPHANIE RAE MANYAK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
949 MORGAN BAY RD, BLUE HILL, ME 04614-5517
(207) 479-5228
Mailing address
949 MORGAN BAY RD, BLUE HILL, ME 04614-5517
(207) 479-5228

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000002379

Other

Enumeration date
04/18/2011
Last updated
04/18/2011
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