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1013574201
MICHAEL KELLY CARTER
NORTHRIDGE, CA
NPI
1013574201
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2019-05-22
Last Update Date
2019-05-22
Business Address
MICHAEL KELLY CARTER
1811 NORDOFF STREET
NORTHRIDGE, CA 91330-0001
Phone number: 818-677-1200
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Mailing Address
MICHAEL KELLY CARTER
2359 MORENO DR
CAMARILLO, CA 93010-2148
Phone number:
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