Individual
KATIE KYZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
608 HINDS BLVD, RAYMOND, MS 39154-8246
(601) 857-3325
Mailing address
PO BOX 1100, RAYMOND, MS 39154-1100
(601) 498-4896
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0779
MS
Other
Enumeration date
12/06/2021
Last updated
12/06/2021
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