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1164935763
STEPHAN BODKIN
CHARLOTTESVILLE, VA
NPI
1164935763
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: VA 0126002357)
Enumeration Date
2017-11-06
Last Update Date
2017-11-06
Business Address
STEPHAN BODKIN MEd, ATC
210 EMMET ST S
CHARLOTTESVILLE, VA 22903-2455
Phone number: 434-924-6184
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Mailing Address
STEPHAN BODKIN MEd, ATC
1657 WICKLIFFE RD
BERRYVILLE, VA 22611-2558
Phone number:
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