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1477846582
STACY LYNN FENNELL
FORT SAM HOUSTON, TX
NPI
1477846582
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
208D00000X General Practice
(Licence: IN 02004134A)
Enumeration Date
2011-05-23
Last Update Date
2014-05-23
Business Address
-- STACY LYNN FENNELL D.O.
3851 ROGER BROOKE DR MCHE-EMR
FORT SAM HOUSTON, TX 78234-4501
Phone number: 210-292-7626
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Mailing Address
-- STACY LYNN FENNELL D.O.
8344 VERSAILLES SE RD
BRADFORD, OH 45308-9602
Phone number: 937-974-8352
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