Individual
KATELYN BANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
507 SPRING ST, BOYNE CITY, MI 49712-1295
(231) 675-9045
Mailing address
507 SPRING ST, BOYNE CITY, MI 49712-1295
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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