Individual
MRS. KATHY KENNEDY MATTHEWS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
504 GEORGIA AVE S, BREMEN, GA 30110-2122
(770) 537-2592
Mailing address
504 GEORGIA AVE S, BREMEN, GA 30110-2122
(770) 537-2592
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT000639
GA
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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