Individual
CHARLES N STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4006 ANGELINA LN, STOCKTON, CA 95212-3133
(209) 808-3109
Mailing address
4006 ANGELINA LN, STOCKTON, CA 95212-3133
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/17/2009
Last updated
11/17/2009
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