Individual
ELIZABETH COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
700 BOB-O-LINK DRIVE, LEXINGTON, KY 40504
(859) 258-8563
Mailing address
1221 S BROADWAY, LEXINGTON, KY 40504-2701
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1195
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TA115738
DRIVERS LICENSE
OH
Enumeration date
01/11/2016
Last updated
01/11/2016
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