Individual
MISS KELLY COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
160 WINDERMERE AVE APT 4603, ELLINGTON, CT 06029-3949
(203) 536-6917
Mailing address
160 WINDERMERE AVE APT 4603, ELLINGTON, CT 06029-3949
(203) 536-6917
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000791
CT
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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