Individual
MR. STEPHEN SOUTHARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.M.A., C.C.H.T.
Contact information
Practice address
2448 ENTERPRISE RD, APT 3, CLEARWATER, FL 33763-1797
(813) 505-9968
Mailing address
2448 ENTERPRISE RD, APT 3, CLEARWATER, FL 33763-1797
(813) 505-9968
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
10/26/2016
Last updated
10/26/2016
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