Individual
IAN CHRISTOPHER STITES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
O&C BLDG M7 0355 MAIL CODE IHA 008, KENNEDY SPACE CENTER, FL 32899-0001
(321) 867-8004
(321) 867-1144
Mailing address
O&C BLDG M7 0355 MAIL CODE IHA 008, KENNEDY SPACE CENTER, FL 32899-0001
(321) 867-8004
(321) 867-1144
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 2989
FL
Other
Enumeration date
03/05/2015
Last updated
03/05/2015
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