Individual
KRISHA KACKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10790 NALL AVE, OVERLAND PARK, KS 66211-1206
(316) 300-1047
Mailing address
10242 W 80TH ST APT 213, OVERLAND PARK, KS 66204-4706
(316) 300-1047
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-01240
KS
Other
Enumeration date
09/21/2018
Last updated
09/21/2018
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