Individual
KALEB JOEL DEFREESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1300 HIGBY RD, MONUMENT, CO 80132-7406
(719) 488-4720
Mailing address
5606 BIG PAW HTS, COLORADO SPRINGS, CO 80919-3774
(574) 612-3548
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.0001709
CO
Other
Enumeration date
07/31/2017
Last updated
07/31/2017
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