| NPI | 1326169079 |
|---|---|
| Former Name | KELLY ANN MCCARTHY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: PA RT000892A) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2007-07-08 |