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Individual
KELLY S WESCOTT
Active
Individual
KELLY S WESCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
200
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1034003
NATIONAL ATHLETIC TRAINING ASSOCIATION
—
01
—
200
ATHLETIC TRAINER PROGRAM
HI
01
—
2000005921
BOARD OF CERTIFICATION
—
Enumeration date
08/07/2017
Last updated
08/07/2017
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