Individual
STEPHANIE L FALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
751 4TH ST, CLEAR LAKE, WI 54005-8505
(715) 418-1102
Mailing address
751 4TH ST, CLEAR LAKE, WI 54005-8505
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/19/2007
Last updated
07/08/2007
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