Individual
KAYLA STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5024 MORRIS THOMAS ROAD, HERMANTOWN, MN 55811
(218) 565-0745
Mailing address
5024 MORRIS THOMAS RD, HERMANTOWN, MN 55811-3747
(218) 260-5246
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/30/2015
Last updated
04/30/2015
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