Individual
MRS. KELLY G MIRUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
5161 RALPH AVE, CINCINNATI, OH 45238
(513) 368-2721
Mailing address
5161 RALPH AVE, CINCINNATI, OH 45238
(513) 368-2721
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT.002038
OH
Other
Enumeration date
06/11/2013
Last updated
06/14/2013
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