Individual
ELISA MCKINLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1025 E 7TH ST, BLOOMINGTON, IN 47405-7109
(812) 855-1561
Mailing address
3048 KENWOOD ST, HAMMOND, IN 46323-1143
(219) 293-7744
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/24/2018
Last updated
01/24/2018
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