Individual
MRS. KELLI MARIE GORMONT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
401 S ROUTE 36, ROARING SPRING, PA 16673-1628
(814) 224-5566
Mailing address
5720 OHIO AVE, ALTOONA, PA 16602-1145
(814) 940-1131
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT003834
PA
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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