Individual
MRS. JESSICA LYN STEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
320 S CHURCH AVE, AZTEC, NM 87410-2107
(505) 486-6412
Mailing address
320 S CHURCH AVE, AZTEC, NM 87410-2107
(505) 486-6412
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
361
NM
Other
Enumeration date
10/15/2014
Last updated
10/15/2014
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