Individual
TINA MARIE STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.T.
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
411530
CA
2471C3402X
Radiography Radiologic Technologist
Primary
411530
CA
Other
Enumeration date
08/03/2008
Last updated
08/03/2008
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