Individual
MR. KELLY J BURNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2301 25TH ST S, FARGO, ND 58103-6104
(701) 280-2406
Mailing address
3928 3RD ST S, MOORHEAD, MN 56560-5602
(218) 236-9913
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
047-87
ND
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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