Individual
MR. GRANT STOVALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
LUBBOCK SPORTS MEDICINE ASSOCIATES, 4110 22ND PL, LUBBOCK, TX 79410
(806) 792-4329
Mailing address
4110 22ND PL, LUBBOCK, TX 79410-1122
(806) 790-1186
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
1123412
TX
2255A2300X
Athletic Trainer
AT1516
TX
Other
Enumeration date
02/07/2006
Last updated
11/22/2011
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