Individual
SOPHIA HAINES GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13662 OLD SPRINGHOUSE CT, LOVETTSVILLE, VA 20180-2957
(540) 454-5130
Mailing address
13662 OLD SPRINGHOUSE CT, LOVETTSVILLE, VA 20180-2957
(540) 454-5130
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/24/2022
Last updated
02/24/2022
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