Individual
MISS STACEY HITZELBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
100 PERIMETER RD, CLEMSON, SC 29634-0001
(864) 656-1876
Mailing address
811 ISSAQUEENA TRL APT 1604, CENTRAL, SC 29630-9397
(864) 656-1952
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
806
SC
Other
Enumeration date
01/22/2007
Last updated
07/08/2007
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