Individual
MRS. STACEY JENSEN RITTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
805 AEROVISTA PL, STE 201, SAN LUIS OBISPO, CA 93401-7919
(805) 788-0805
(805) 788-0845
Mailing address
50 MALIBU CT, GROVER BEACH, CA 93433-2821
(805) 788-0805
(805) 788-0845
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/26/2006
Last updated
07/08/2007
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