Individual
COLLIN LANE WESCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
310 COLLEGE ST, BARBOURVILLE, KY 40906-1410
(606) 546-4151
Mailing address
104 FAULKNER ST APT 201, BARBOURVILLE, KY 40906-1539
(260) 479-0661
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.0001920
CO
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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