Individual
KAITLIN BLIGH LAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, L
Contact information
Practice address
1140 EDWARDS VILLAGE, B-105, EDWARDS, CO 81632
(970) 569-3240
(970) 569-3260
Mailing address
PO BOX 2743, EDWARDS, CO 81632-2743
(970) 569-3240
(970) 569-3260
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-985
CO
Other
Enumeration date
12/02/2011
Last updated
12/02/2011
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