Individual
KALYN FORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(513) 373-5913
Mailing address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003762A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/09/2021
Last updated
12/04/2024
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