Individual
MS. KELCEY GRANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10430 AUSTIN PL, MCCORDSVILLE, IN 46055-9623
(317) 435-6405
Mailing address
10430 AUSTIN PL, MCCORDSVILLE, IN 46055-9623
(317) 435-6405
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390200000X
22555A2300X
IN
Enumeration date
06/26/2017
Last updated
07/21/2022
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