Individual
MS. TERRA NICOLE MACKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS LAT ATC
Contact information
Practice address
3100 W MCCORMICK ST, WICHITA, KS 67213-2008
(316) 942-4291
(316) 942-4483
Mailing address
4212 N RUSHWOOD ST, BEL AIRE, KS 67226-1465
(316) 993-5220
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00391
KS
Other
Enumeration date
07/20/2006
Last updated
01/17/2017
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