Individual
KEVIN STEVEN REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
5500 KNOLL NORTH DR, COLUMBIA, MD 21045-2370
(443) 542-0062
Mailing address
745 KENTUCKY AVE SE, WASHINGTON, DC 20003-3113
(571) 528-0670
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2162
NC
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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