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Individual

KAITLIN COYNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
420 MYRTLE GREENS DR APT B, CONWAY, SC 29526-9031
(845) 729-0803
Mailing address
420 MYRTLE GREENS DR APT B, CONWAY, SC 29526-9031
(845) 729-0803

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1596
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2000003185
NATABOC
Enumeration date
03/25/2016
Last updated
03/25/2016
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