Individual
MADISSEN KAILYN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2210 9TH ST APT 202, CHARLESTON, IL 61920-4020
(682) 367-3823
Mailing address
2210 9TH ST APT 202, CHARLESTON, IL 61920-4020
(682) 367-3823
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096005381
IL
Other
Enumeration date
01/09/2023
Last updated
01/09/2023
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