| NPI | 1578773065 |
|---|---|
| Former Name | KERRY LEE WINGARDNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT002181) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2017-01-02 |