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Individual

MS. KAYLA WINCKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
305 WISTERIA ST, RUSTON, LA 71272-0001
(954) 864-5007
Mailing address
4744 NW 5TH PL, COCONUT CREEK, FL 33063-6742
(954) 864-5007

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22
RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS
Enumeration date
05/22/2017
Last updated
05/22/2017
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