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1053089482
KYEONGTAK SONG
LEXINGTON, KY
NPI
1053089482
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2021-08-31
Last Update Date
2021-08-31
Business Address
Dr. KYEONGTAK SONG PhD, ATC
720 SPORTS CENTER DRIVE
LEXINGTON, KY 40506-0001
Phone number: 859-323-9850
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Mailing Address
Dr. KYEONGTAK SONG PhD, ATC
2775 POLO CLUB BLVD UNIT 305
LEXINGTON, KY 40509-8362
Phone number: 704-497-0894
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