Individual
STEPHANIE JEANE CLYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1647 S FOUNTAINHEAD RD, FORT MYERS, FL 33919-6808
(239) 898-0593
Mailing address
1647 S FOUNTAINHEAD RD, FORT MYERS, FL 33919-6808
(239) 898-0593
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1928
TN
Other
Enumeration date
04/04/2016
Last updated
04/04/2016
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