Individual
STEPHANIA MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
7300 REINHARDT CIR, WALESKA, GA 30183-2981
(770) 720-5821
Mailing address
7300 REINHARDT CIR, WALESKA, GA 30183-2981
(770) 720-5821
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002293
GA
Other
Enumeration date
07/30/2014
Last updated
07/30/2014
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