Individual
KELLY COLWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
340 11TH ST E APT 3209, BRADENTON, FL 34208-1272
(651) 764-9870
Mailing address
340 11TH ST E APT 3209, BRADENTON, FL 34208-1272
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2020
Last updated
08/02/2022
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