Individual
BENEDICT WILLIAM STOLLBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
5800 AIRLINE DR, METAIRIE, LA 70003-3876
(504) 733-0255
Mailing address
537 AVENUE OF PATRIOTS ST, STARKVILLE, MS 39759-3103
(262) 689-1236
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0558
MS
Other
Enumeration date
09/09/2014
Last updated
09/09/2014
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