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Individual

STEPHANIE HUNTSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MED, LAT, ATC

Contact information

Practice address
980 KELLY JOHNSON DR, SUITE 200, LAS VEGAS, NV 89119-3785
(702) 352-0026
Mailing address
9616 LIGHTHEART AVE, LAS VEGAS, NV 89148-5517
(703) 819-4414

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0126001746
VA
2255A2300X
Athletic Trainer
Primary
0506370
NV
2255A2300X
Athletic Trainer
AT.0001085
CO

Other

Enumeration date
05/21/2016
Last updated
05/21/2016
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