Individual
STACEY CHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
13537 BARRETT PARKWAY DR STE 105, BALLWIN, MO 63021-5896
(815) 274-7026
Mailing address
14116 FOREST RIDGE DR, NORTH POTOMAC, MD 20878-4824
(240) 994-7149
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2019032528
MO
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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