Individual
MR. KYLE WITKEMPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC.,LAT
Contact information
Practice address
1640 E STATE ROAD 44 STE A, SHELBYVILLE, IN 46176-4030
(317) 392-5855
Mailing address
7329 POPPYSEED DR, INDIANAPOLIS, IN 46237-3675
(317) 889-0736
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000688A
IN
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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