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Individual

MRS. EMILY IRENE KENYON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC, CKTP, ITAT

Contact information

Practice address
12800 MISSISSIPPI PKWY STE A101, CROWN POINT, IN 46307-6901
(219) 662-5266
Mailing address
435 W 94TH AVE APT 717, CROWN POINT, IN 46307-6233

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002858A
IN

Other

Enumeration date
08/16/2017
Last updated
08/16/2017
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