Individual
STACY RIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.T.C., L.A.T.
Contact information
Practice address
1205 WORDSWORTH CT, HARRISONBURG, VA 22802-4662
(607) 765-6303
Mailing address
1205 WORDSWORTH CT, HARRISONBURG, VA 22802-4662
(607) 765-6303
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126001807
VA
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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