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Individual

KACEY AYRES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LAT, ATC, CES

Contact information

Practice address
330 E VERNON AVE APT 8, NORMAL, IL 61761-6819
(317) 225-0411
Mailing address
10364 WATER CREST DR, FISHERS, IN 46038-7477
(317) 225-0411

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36003452A
IN
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
09/12/2016
Last updated
04/23/2021
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