Individual
KYNDRA GINELL LONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
345 N COLLEGE ST, CHARLOTTE, NC 28202-2113
(980) 224-0994
Mailing address
PO BOX 32394, CHARLOTTE, NC 28232-2394
(980) 224-0994
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-2869
NC
Other
Enumeration date
04/21/2017
Last updated
04/21/2017
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