Individual
KATELYN NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
1601 MAPLE ST, CARROLLTON, GA 30118-0001
(815) 762-0597
Mailing address
121 CHAUCER LN, CARROLLTON, GA 30117-6407
(815) 762-0597
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT004376
GA
Other
Enumeration date
09/05/2023
Last updated
09/05/2023
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