Individual
MR. LANDON WADE KERSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1105 RENITA WAY, MOORE, OK 73160-8710
(405) 819-1840
Mailing address
1105 RENITA WAY, MOORE, OK 73160-8710
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
496
OK
Other
Enumeration date
07/07/2010
Last updated
07/07/2010
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