Individual
STACEY R. KOFMAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC, PTA
Contact information
Practice address
50 EMBARCADERO RD, PALO ALTO HIGH SCHOOL, PALO ALTO, CA 94301-2321
(650) 329-3892
(650) 566-0612
Mailing address
49 SHOWERS DR, J324, MOUNTAIN VIEW, CA 94040-1463
(650) 949-4561
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/17/2006
Last updated
07/08/2007
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