Individual
MR. JASON BRADLEY KITCHENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
1615 STANLEY ST, DEPARTMENT OF PHYSICAL EDUCATION & HUMAN PERFORMANCE, NEW BRITAIN, CT 06050-2439
(203) 417-7455
Mailing address
1670 FARMINGTON AVE, UNIT 6, UNIONVILLE, CT 06085-1229
(203) 417-7455
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000267
CT
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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