Individual
KATHY STOMPRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2301 25TH ST S, FARGO, ND 58103-6104
(701) 237-9712
Mailing address
2625 39TH AVE S, FARGO, ND 58104-7026
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
045-87
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000050628
NATA BOC
—
01
—
045-87
NDATA
ND
Enumeration date
10/08/2014
Last updated
10/08/2014
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