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Individual

ALYSSA ANN STOUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
325 S 1ST AVE, BROKEN BOW, NE 68822-2213
(308) 872-5111
(308) 872-5115
Mailing address
325 S 1ST AVE, BROKEN BOW, NE 68822-2213
(308) 872-5111
(308) 872-5115

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
857
NH

Other

Enumeration date
06/20/2023
Last updated
06/20/2023
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