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General NPI Number Information
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NPI Number | 1649487141
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Entity Type | Individual
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Provider Name | CHAD STEFANO M.S., ATC, LAT
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Gender | Male
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 12/23/2008
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Provider Practice Location Address
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Address Line | 1209 MITCHELL CTR
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City | MOBILE
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State | AL
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Zip | 36688-0001
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Country | US
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Telephone | 251-460-6874
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Fax |
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Provider Business Mailing Address
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Address Line | 1200 SOMERBY DR APT 306
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City | MOBILE
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State | AL
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Zip | 36695-5427
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AT001234
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | AL
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