Individual
ELI KENAN TEATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4326 VINCE RD, NICHOLASVILLE, KY 40356-9440
(859) 797-9760
Mailing address
4326 VINCE RD, NICHOLASVILLE, KY 40356-9440
(859) 797-9760
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
10/07/2024
Last updated
10/07/2024
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