Individual
KATHRYN FAYE DEBLAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
19 DULWICH WAY, CLAYTON, NC 27527-3339
(919) 749-5915
Mailing address
19 DULWICH WAY, CLAYTON, NC 27527-3339
(919) 749-5915
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2669
NC
Other
Enumeration date
07/01/2015
Last updated
07/01/2015
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