Madison Stagman

NPI #1164047239 in Mascoutah, Illinois

Provider Information

NPI Number: 1164047239
Entity Type: Individual
Name: Madison Stagman
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jun 14, 2020
Last Updated: Jun 14, 2020

Practice Location

Address: 280 DOUGLAS AVE APT 4
City: Mascoutah
State: Illinois
ZIP Code: 62258-2963
Phone: (608) 379-3304

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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