| NPI | 1255098810 |
|---|---|
| Former Name | KAY RUTH BELLVILLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: UT 049602402) |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2021-11-18 |