Individual
KAITLYN ANN CARLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11 KENNEDY CT, PHILO, IL 61864-9759
(217) 722-7698
Mailing address
11 KENNEDY CT, PHILO, IL 61864
(217) 722-7698
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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