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Individual

MS. KELLY LYNN BACHUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MED, ATC

Contact information

Practice address
500 LINCOLN DR, MADISON, WI 53706-1314
(608) 515-3893
(608) 265-4736
Mailing address
6633 GETTYSBURG DR, MADISON, WI 53705-4206
(512) 297-0277

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1155
TN
2255A2300X
Athletic Trainer
AT0360
MS

Other

Enumeration date
11/13/2006
Last updated
07/21/2022
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