Individual
MCKENSIE ELLYN VANOSDOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
475 PERSIMMON DR, NORTH VERNON, IN 47265-2459
(812) 592-7725
Mailing address
475 PERSIMMON DR, NORTH VERNON, IN 47265-2459
(812) 592-7725
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/22/2015
Last updated
09/22/2015
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