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Individual

MARY S STANFORD

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
P.T., O.C.S.

Contact information

Practice address
42007 FOX FARM RD., SUITE #2, BIG BEAR LAKE, CA 92315
(909) 866-6202
(909) 866-6203
Mailing address
PO BOX 1928, BLUE JAY, CA 92317-1928
(909) 866-6202
(909) 866-6203

Taxonomy

Speciality
Code
Description
License number
State
2251E1200X
Ergonomics Physical Therapist
Primary
PT19301
CA
2251X0800X
Orthopedic Physical Therapist
PT19301
CA

Other

Enumeration date
04/26/2006
Last updated
09/11/2025
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