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1164204350
TRACI LYNN STOUT
RAPID CITY, SD
NPI
1164204350
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Former Name
TRACI LYNN CORCORAN
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: SD 0695)
Enumeration Date
2023-10-20
Last Update Date
2023-10-20
Business Address
TRACI LYNN STOUT MAT, LAT, ATC
1635 CAREGIVER CIR
RAPID CITY, SD 57702-8529
Phone number: 605-755-6100
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Mailing Address
TRACI LYNN STOUT MAT, LAT, ATC
1635 CAREGIVER CIR
RAPID CITY, SD 57702-8529
Phone number:
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