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Individual

NICOLE FILLINGAME

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC, LAT, CES, PES

Contact information

Practice address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3696
(816) 855-1993
Mailing address
2501 NW MILL DR, BLUE SPRINGS, MO 64015-3277
(816) 988-7976

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2008025047
MO
2255A2300X
Athletic Trainer
24-00716
KS

Other

Enumeration date
06/23/2014
Last updated
06/23/2014
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