Individual
KELSI HUSEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
800 UNIVERSITY DR, MARYVILLE, MO 64468-6015
(712) 542-9053
Mailing address
2090 TOLBERT AVE, CLARINDA, IA 51632-4060
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0011069
IA
2255A2300X
Athletic Trainer
607
NE
Other
Enumeration date
09/10/2012
Last updated
09/10/2012
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