Individual
KYLIE BOLDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1105 SUNSET AVE, MANHATTAN, KS 66502-3739
(402) 212-5006
Mailing address
2401 W BROADWAY APT 605, COLUMBIA, MO 65203-7616
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
12/21/2022
Last updated
12/21/2022
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