Individual
KIARA ANN LEBOUTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
2400 E CAPITOL DR, APPLETON, WI 54911-8728
(920) 642-1313
Mailing address
996 3RD ST APT 8B, MENASHA, WI 54952-3258
(920) 642-1313
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3121-39
WI
Other
Enumeration date
10/05/2023
Last updated
10/05/2023
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