| 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 |