Individual
MS. TAMELA ULILA STOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1103 E BOXELDER RD STE U, GILLETTE, WY 82718-5582
(307) 686-8177
Mailing address
66 DOUBLE TREE RD, ROZET, WY 82727-8471
(308) 778-6518
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
149
WY
2255A2300X
Athletic Trainer
44
NE
Other
Enumeration date
07/21/2006
Last updated
08/17/2021
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