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Individual

KEVIN GULLION

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(812) 571-0167
Mailing address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(812) 571-0167

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002690A
IN

Other

Enumeration date
08/15/2014
Last updated
12/04/2024
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