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Individual

MR. DENNIS WILLIAM KELLINGTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MA, ATC

Contact information

Practice address
MANLEY FIELD HOUSE, SYRACUSE, NY 13244-5020
(315) 443-4775
(315) 443-5057
Mailing address
MANLEY FIELD HOUSE, SYRACUSE, NY 13244-5020
(315) 443-4775
(315) 443-5057

Taxonomy

Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
001364-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001364-1
ATHLETIC TRAINER LICENSE
NY
Enumeration date
07/09/2006
Last updated
07/08/2007
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