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Individual

GRETEL CABALLERO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2301 ROCKFORD LN, LOUISVILLE, KY 40216-2948
(502) 419-6705
Mailing address
5504 EIGHT BELLS LN APT 104, LOUISVILLE, KY 40258-1077
(502) 419-6705

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
304211
ATHLETIC TRAINING STUDENT
KY
Enumeration date
12/17/2020
Last updated
02/15/2022
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