Individual
STEPHANIE ANN BURDETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
1243 CAMARO CT, PIQUA, OH 45356-9793
(937) 510-1303
Mailing address
1243 CAMARO CT, PIQUA, OH 45356-9793
(937) 510-1303
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002986
OH
Other
Enumeration date
12/08/2015
Last updated
12/08/2015
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