Individual
NICOLE HERGERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
28310 SE L RD, JETMORE, KS 67854-5436
(620) 393-0001
Mailing address
28310 SE L RD, JETMORE, KS 67854-5436
(620) 393-0001
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
789
OK
Other
Enumeration date
01/03/2015
Last updated
01/03/2015
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