Individual
MR. KYLE JOSEPH PROTHRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
2145 HENRY TECKLENBURG DR, SUITE 220, CHARLESTON, SC 29414-5893
(843) 872-2720
Mailing address
2145 HENRY TECKLENBURG DR, SUITE 220, CHARLESTON, SC 29414-5893
(843) 872-2720
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050702214
NATABOC
—
01
—
1248
SCDHEC
SC
Enumeration date
07/18/2007
Last updated
10/01/2016
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