Individual
STACEY GAVEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, ATC, LAT
Contact information
Practice address
101 BRANIGIN BLVD, SPURLOCK 213, FRANKLIN, IN 46131-2598
(317) 738-8123
(317) 738-8248
Mailing address
1192 BALATON LN, 208, GREENWOOD, IN 46143-8019
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002199A
IN
Other
Enumeration date
09/30/2015
Last updated
09/30/2015
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