Individual
ASHLEY NICOLE KECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
2811 CLEARWATER AVE, BLOOMINGTON, IL 61704-8190
(574) 361-9008
Mailing address
2811 CLEARWATER AVE, BLOOMINGTON, IL 61704-8190
(574) 361-9008
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003425
IL
Other
Enumeration date
02/23/2015
Last updated
02/23/2015
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