Individual
AUSTIN HILLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
618 8TH ST, BALDWIN CITY, KS 66006-6009
(785) 594-8488
Mailing address
618 8TH ST, BALDWIN CITY, KS 66006-6009
(785) 594-8488
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-00783
—
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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