Individual
KELLY RIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, CSCS
Contact information
Practice address
15 CHRISKEN DR, GLENMONT, NY 12077-3249
(518) 598-3973
Mailing address
15 CHRISKEN DR, GLENMONT, NY 12077-3249
(518) 598-3973
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1958
MA
2255A2300X
Athletic Trainer
Primary
67 001567
NY
Other
Enumeration date
04/22/2014
Last updated
04/22/2014
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