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1063888113
JENNIFER STAVENGER
SIOUX FALLS, SD
NPI
1063888113
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Former Name
JENNIFER SANDQUIST
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: SD 0315)
Enumeration Date
2015-08-12
Last Update Date
2015-08-12
Business Address
JENNIFER STAVENGER ATC
3909 E BROOKLINE DR
SIOUX FALLS, SD 57103-5702
Phone number: 605-360-6135
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Mailing Address
JENNIFER STAVENGER ATC
3909 E BROOKLINE DR
SIOUX FALLS, SD 57103-5702
Phone number: 605-360-6135
Copy
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