Individual
MR. M. KELLY CRUISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3205 SHREVE RD, WOOSTER, OH 44691-4439
(330) 264-2114
Mailing address
2572 E TOLBERT RD, WOOSTER, OH 44691-9417
(330) 202-9035
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000522
OH
Other
Enumeration date
07/06/2013
Last updated
07/06/2013
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