Organization
VIA CHRISTI REGIONAL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMERON KEITH CLARK LATC (HEAD CERTIFIED ATHLETIC TRAINER)
(316) 942-4291
Entity
Organization
Contact information
Practice address
3100 W MCCORMICK ST, WICHITA, KS 67213-2008
(316) 942-4291
(316) 942-4483
Mailing address
3100 W MCCORMICK ST, WICHITA, KS 67213-2008
(316) 942-4291
(316) 942-4483
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00037
KS
Other
Enumeration date
01/08/2007
Last updated
08/22/2020
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