Individual
KELSEY CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
096.003974
IL
2255A2300X
Athletic Trainer
Primary
A0001100
MD
Other
Enumeration date
01/21/2017
Last updated
09/14/2021
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