Stout, Alyssa Colleen Tendall

Stout, Alyssa Colleen Tendall is an individual health care provider with primary practice located at 215 5Th St , Marietta OH 45750-4033. She recently has 3 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is her primary health care specialty. Stout, Alyssa Colleen Tendall can be contacted via phone (740) 376-4575.

Contact Information

Primary practice address
215 5Th St Marietta OH 45750-4033
Phone: (740) 376-4575
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Rehabilitation Practitioner 225400000X AT005607 Ohio
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X AT005607 Ohio
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X AT005607 Ohio

Profile Details

NPI number 1487058343
LBN Legal business name Stout, Alyssa Colleen Tendall
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2014
Last updated Feb 11th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487058343 NPPES
Ohio Other AT005607 ATHLETIC TRAINER

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