Individual
MR. KYLE LYNN MABRY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
275 LITHIA WAY, ASHLAND, OR 97520
(541) 482-6748
Mailing address
PO BOX 1214, PHOENIX, OR 97535
(541) 512-1606
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-AT-1000469
OR
Other
Enumeration date
05/15/2006
Last updated
07/08/2007
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