Individual
KELLY WHITNEY-BABCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.T.C., L.A.T.
Contact information
Practice address
1001 E 17TH ST, BLOOMINGTON, IN 47408-1590
(916) 880-8276
Mailing address
1471 W ALLEN ST, BLOOMINGTON, IN 47403-2950
(916) 880-8276
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002479A
IN
Other
Enumeration date
11/09/2015
Last updated
11/09/2015
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