Individual
KALEB BOYDSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC
Contact information
Practice address
1111 RING RD, ELIZABETHTOWN, KY 42701-4900
(816) 383-4380
Mailing address
110 SILVER CREEK CT, APT 2A, ELIZABETHTOWN, KY 42701-7277
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22
RESPIRATORY, DEVELOPMENTAL, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS
—
Enumeration date
03/07/2010
Last updated
06/26/2011
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