Individual
MRS. CARYN KAY STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2448 S 102ND ST, SUITE 340, MILWAUKEE, WI 53227-2466
(414) 329-2500
Mailing address
8261 WALDORA RD, SIREN, WI 54872-8759
(715) 349-8757
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5291-024
WI
Other
Enumeration date
07/05/2007
Last updated
07/09/2007
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