Individual
KAYLA LYNN FIVEASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1816 HUNTSVILLE HWY, FAYETTEVILLE, TN 37334-3787
(931) 228-5585
Mailing address
1185 COUNTY ROAD 1000 W, LINTON, IN 47441
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2385
TN
2255A2300X
Athletic Trainer
Primary
36003559A
IN
Other
Enumeration date
04/18/2020
Last updated
05/18/2023
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