Individual
KEVIN PULLYBLANK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AT
Contact information
Practice address
3193 JANE ST, CALEDONIA, NY 14423-1024
(585) 944-9277
Mailing address
3193 JANE ST, CALEDONIA, NY 14423-1024
(585) 944-9277
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
004450
OH
Other
Enumeration date
07/30/2015
Last updated
07/30/2015
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