Individual
KELLY S BARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
150 BEAR RUN, WACO, TX 76711-1267
(254) 709-4566
Mailing address
150 BEAR RUN, WACO, TX 76711-1267
(254) 709-4566
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT3404
TX
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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