Individual
KYLA RAYE EBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-8355
(270) 798-8400
Mailing address
3129 BROOK HILL DR, CLARKSVILLE, TN 37042-8666
(847) 529-4119
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003818
IL
2255A2300X
Athletic Trainer
2808
TN
2255A2300X
Athletic Trainer
AT2289
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
096.003818
LICENCED ATHLETIC TRAINER
IL
01
—
2808
ATHLETIC TRAINER LICENSE
TN
01
—
AT2289
ATHLETIC TRAINER LICENSE
KY
Enumeration date
07/06/2018
Last updated
08/14/2026
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