Individual
MRS. KELLY ALISON STALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1145 KING RD, IMMACULATA, PA 19345-9903
(610) 647-4400
Mailing address
2 VICTORY WAY, LIMERICK, PA 19468-1342
(610) 812-4333
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT-002345-A
PA
Other
Enumeration date
07/12/2006
Last updated
07/08/2007
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