Individual
TERRICKA STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT, MS
Contact information
Practice address
885 WEST 16TH ST., FORT LEONARD WOOD, MO 65473
(573) 596-7174
Mailing address
300 HISTORIC 66 E APT 4, WAYNESVILLE, MO 65583-3235
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0928
AZ
Other
Enumeration date
02/03/2015
Last updated
02/03/2015
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