Individual
KYLE PATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1122 REGIMENT DR NW, ACWORTH, GA 30101-8462
(812) 621-2191
Mailing address
1122 REGIMENT DR NW, ACWORTH, GA 30101-8462
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002654
GA
Other
Enumeration date
06/13/2014
Last updated
04/03/2015
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