Individual
KIRSTIE JONES BOUTWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
3300 SIEGEL RD, MURFREESBORO, TN 37129-5844
(615) 904-3800
Mailing address
115 SPRING CIR, SMYRNA, TN 37167-4820
(904) 412-1524
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0000001809
TN
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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