Individual
MR. KENNETH COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
100 E UNIVERSITY, MAGNOLIA, AR 71753-2181
(870) 235-4142
(870) 235-4988
Mailing address
100 E UNIVERSITY, P.O. BOX 8800, MAGNOLIA, AR 71753-2181
(870) 235-4142
(870) 235-4988
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT- 165
AR
Other
Enumeration date
07/20/2006
Last updated
07/08/2007
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