Individual
KELLI BUNDZA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
5321 GEORGIA PEACH AVE, PORT ORANGE, FL 32128-7534
(386) 852-4137
Mailing address
5321 GEORGIA PEACH AVE, PORT ORANGE, FL 32128-7534
(386) 852-4137
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 3002
FL
Other
Enumeration date
07/18/2014
Last updated
07/18/2014
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