Individual
BRIAN JONATHAN STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
2801 W BANCROFT ST, TOLEDO, OH 43606-3390
(734) 216-5132
Mailing address
7968 RAMBLEWOOD CT, YPSILANTI, MI 48197-7170
(734) 216-5132
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002191
MI
Other
Enumeration date
09/12/2016
Last updated
05/10/2019
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