Individual
MR. STEPHAN MILO WALZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4202 E FOWLER AVE, ATH100, TAMPA, FL 33620-8001
(813) 974-3506
(813) 974-8541
Mailing address
4604 GLENSIDE CIR, TAMPA, FL 33624-4312
(813) 908-6873
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL75
FL
Other
Enumeration date
02/07/2006
Last updated
05/30/2019
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