Individual
MR. KENDALL LAURENCE STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC, CES, PES
Contact information
Practice address
6725 RIDGE AVE, APARTMENT 302, PHILADELPHIA, PA 19128-2452
(760) 703-4852
Mailing address
6725 RIDGE AVE, APARTMENT 302, PHILADELPHIA, PA 19128-2452
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT006370
PA
Other
Enumeration date
02/15/2016
Last updated
02/15/2016
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