Individual
KRISTEN CORNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
20460 ANACONDA RD, FORT DRUM, NY 13603
(719) 428-9621
Mailing address
9646D BUTLER LOOP, FORT DRUM, NY 13603-3217
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.0002144
CO
Other
Enumeration date
07/28/2020
Last updated
08/10/2022
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