Individual
DR. STEPHANIE DIANE MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, ATC
Contact information
Practice address
5275 N CAMPUS DR, M/S SG28, FRESNO, CA 93740-0001
(559) 278-0255
Mailing address
5275 N CAMPUS DR, M/S SG28, FRESNO, CA 93740-0001
(559) 278-0255
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/03/2015
Last updated
08/14/2020
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