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Individual

KYLIE FENDRICK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7331 LACOSTA CT, TERRE HAUTE, IN 47802-4998
(812) 243-5912
Mailing address
7331 LACOSTA CT, TERRE HAUTE, IN 47802-4998

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
01/19/2017
Last updated
01/19/2017
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