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Individual

MISS KELSEA RENE KOCAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
338 LEXINGTON AVE, LEXINGTON, KY 40506-0001
(800) 928-2287
Mailing address
6209 SIEBERT ST, MIDLAND, MI 48640-2723
(989) 430-0272

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1381
KY

Other

Enumeration date
11/05/2017
Last updated
11/05/2017
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