Individual
KEVIN LICHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
522 28TH AVE, GREELEY, CO 80634
(970) 286-4188
Mailing address
522 28TH AVE, GREELEY, CO 80634-2635
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.0001867
CO
Other
Enumeration date
11/30/2017
Last updated
07/23/2018
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