Individual
STACY BODINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 PRINCETON PIKE, LAWRENCEVILLE, NJ 08648-1205
(609) 203-1642
Mailing address
38 REVOLUTION WAY APT 112, EWING, NJ 08628-1940
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00312000
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
FL
Other
Enumeration date
12/23/2015
Last updated
12/17/2025
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