Individual
MS. KATIE DEE WILLMOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
318 S MAIN AVE STE 1, PLATTE, SD 57369-2120
(605) 337-3102
(605) 337-3104
Mailing address
PO BOX 284, PLATTE, SD 57369-0284
(605) 337-3102
(605) 337-3104
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0480
SD
Other
Enumeration date
01/23/2020
Last updated
01/23/2020
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