Individual
KEYONNA LASHAY KIRTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 N FAIRVIEW ST, LOCK HAVEN, PA 17745-2342
(570) 484-2011
Mailing address
185 PEACE ST, STRATFORD, CT 06615-5552
(203) 572-7304
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/27/2017
Last updated
11/27/2017
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