Individual
STEPHEN LLOYD MUNDEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
727 CIELO AZUL APT B7, ALAMOSA, CO 81101-8816
(801) 916-4502
Mailing address
727 CIELO AZUL APT B7, ALAMOSA, CO 81101-8816
(801) 916-4502
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000018898
BOARD OF CERTIFICATION
—
Enumeration date
11/10/2016
Last updated
11/10/2016
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