Individual
MISS JESSICA ANN STADING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
9120 W LOOMIS RD STE 100, FRANKLIN, WI 53132-9083
(414) 858-1740
(414) 858-1741
Mailing address
26919 113TH ST, TREVOR, WI 53179-9719
(262) 344-1011
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1267-39
WI
Other
Enumeration date
07/03/2012
Last updated
07/03/2012
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