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1275186587
COLLIN LANE WESCO
BARBOURVILLE, KY
NPI
1275186587
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: CO AT.0001920)
Enumeration Date
2019-07-17
Last Update Date
2019-07-17
Business Address
COLLIN LANE WESCO ATC
310 COLLEGE ST
BARBOURVILLE, KY 40906-1410
Phone number: 606-546-4151
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Mailing Address
COLLIN LANE WESCO ATC
104 FAULKNER ST APT 201
BARBOURVILLE, KY 40906-1539
Phone number: 260-479-0661
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