Individual
KEMUEL STUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LATC
Contact information
Practice address
655 CRAIG RD STE 160, SAINT LOUIS, MO 63141-7173
(636) 497-2691
Mailing address
655 CRAIG RD STE 160, SAINT LOUIS, MO 63141-7173
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2015035140
MO
Other
Enumeration date
05/18/2016
Last updated
05/18/2016
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