Individual
KELSEY JO LANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3120 MAJESTIC VIEW WALK, LEXINGTON, KY 40511-8882
(724) 249-7822
Mailing address
3120 MAJESTIC VIEW WALK, LEXINGTON, KY 40511-8882
(724) 249-7822
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1497
KY
246Z00000X
Other Specialist/Technologist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/22/2017
Last updated
10/22/2020
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