Individual
MISS STACEY BAYNHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC SCAT
Contact information
Practice address
320 CORLEY MILL RD, LEXINGTON, SC 29072-8403
(803) 821-0848
Mailing address
111 SPILLWAY BLVD, LEXINGTON, SC 29072-3418
(843) 446-1954
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
282
SC
Other
Enumeration date
11/18/2014
Last updated
11/18/2014
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