Individual
KELLI WILKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA ATC
Contact information
Practice address
15411 TUCKER ST, BENNINGTON, NE 68007-1859
(402) 250-4117
Mailing address
15411 TUCKER ST, BENNINGTON, NE 68007-1859
(402) 250-4117
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
573
NE
Other
Enumeration date
02/17/2016
Last updated
02/17/2016
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