Individual
STEPHANIE JO WITTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1300 17TH AVE NORTH, FARGO, ND 58102-5810
(701) 730-6260
Mailing address
1300 17TH AVE NORTH, FARGO, ND 58102
(701) 730-6260
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
700-15
ND
Other
Enumeration date
12/02/2020
Last updated
12/02/2020
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