Individual
STACIE LYN LONQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1255 LIBERTY ST, REDDING, CA 96001-0814
(530) 246-2467
(530) 224-2229
Mailing address
1255 LIBERTY ST, REDDING, CA 96001-0814
(530) 246-2467
(530) 224-2229
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
029702647
—
Other
Enumeration date
01/26/2018
Last updated
01/26/2018
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