Individual
MYRANDA STAUCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2901 STADIUM DRIVE, TCU BOX 290315, FORT WORTH, TX 76129
(210) 279-1581
Mailing address
2901 STADIUM DRIVE, TCU BOX 290315, FORT WORTH, TX 76129
(210) 279-1581
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/03/2017
Last updated
04/03/2017
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