Individual
KIANNE FERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3000 COLLEGE AVE, BLUEFIELD, VA 24605-2050
(800) 872-0175
Mailing address
143 CEDAR RIDGE RD, PRINCETON, WV 24739-1501
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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