Individual
KELSEY ANN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
339 BUHL BLVD, SHARON, PA 16146-3711
(724) 866-6203
Mailing address
339 BUHL BLVD, SHARON, PA 16146-3711
(724) 866-6203
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/05/2019
Last updated
05/06/2022
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