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Individual

KELLY FICKES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
4231 MONUMENT WALL WAY, APT 453, FAIRFAX, VA 22030-8433
(240) 925-1797
Mailing address
4231 MONUMENT WALL WAY, APT 453, FAIRFAX, VA 22030-8433

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000693
VA

Other

Enumeration date
03/06/2017
Last updated
03/06/2017
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