Individual
DR. KYEONGTAK SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, ATC
Contact information
Practice address
720 SPORTS CENTER DRIVE, LEXINGTON, KY 40506-0001
(859) 323-9850
Mailing address
2775 POLO CLUB BLVD UNIT 305, LEXINGTON, KY 40509-8362
(704) 497-0894
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/31/2021
Last updated
08/31/2021
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