NPI | 1134659626 |
---|---|
Former Name | KELLY CHENEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: UT 10272228-4810) |
Enumeration Date | 2017-06-15 |
Last Update Date | 2022-07-21 |