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1013572874
KELLI HANSEN
AFTON, WY
NPI
1013572874
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: WY 115)
Enumeration Date
2019-05-07
Last Update Date
2019-05-07
Business Address
KELLI HANSEN LAT, ATC
901 ADAMS ST
AFTON, WY 83110-9621
Phone number: 307-885-5800
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Mailing Address
KELLI HANSEN LAT, ATC
PO BOX 1482
AFTON, WY 83110-1482
Phone number: 208-850-9039
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