Individual
MS. KELLY JANE WILICHOSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.T.,C.
Contact information
Practice address
237 ROUTE 108 STE 101, SOMERSWORTH, NH 03878-1517
(603) 749-6686
Mailing address
833 PORTSMOUTH AVE, GREENLAND, NH 03840-2134
(603) 969-3314
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
243
NH
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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