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Individual

KELSEY K LABODI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
901 8TH ST S, MOORHEAD, MN 56562-0001
(701) 490-0552
Mailing address
5001 AMBER VALLEY PKWY S APT 306, FARGO, ND 58104-8686
(701) 490-0552

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2000025626
BOC NUMBER
Enumeration date
03/27/2018
Last updated
03/27/2018
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