Individual
GARY STEVANUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
415 EISENHOWER, BALDWIN CITY, KS 66006
(785) 594-2725
(785) 594-2858
Mailing address
PO BOX 67, BALDWIN CITY, KS 66006-0067
(785) 594-2725
(785) 594-2858
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00166
KS
Other
Enumeration date
09/19/2014
Last updated
09/19/2014
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