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Individual

MS. KELLY ELIZABETH WALSH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, ATC, LAT, PES

Contact information

Practice address
UNIVERSITY OF CALIFORNIA SANTA BARBARA, DEPARTMENT OF INTERCOLLEGIATE ATHLETICS, ICA BUILDING, SANTA BARBARA, CA 93106-5200
(805) 893-3424
(805) 893-5420
Mailing address
4025 E. SKELTON CANYON CIR., WESTLAKE VILLAGE, CA 91362-4232

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
AH1421-AT
MA
174400000X
Specialist
Primary
NATABOC 08012030

Other

Enumeration date
05/17/2007
Last updated
08/21/2008
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