Individual
NATHAN STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
12616 W EDGEMONT AVE, AVONDALE, AZ 85392-5510
(623) 326-4414
Mailing address
12616 W EDGEMONT AVE, AVONDALE, AZ 85392-5510
(623) 326-4414
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000552
AZ
Other
Enumeration date
12/28/2018
Last updated
12/28/2018
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