Individual
KAILENE ALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5519 NORTE DAME AVE, RIVER OAKS, TX 76114
(330) 858-2047
Mailing address
5519 NOTRE DAME AVE, RIVER OAKS, TX 76114-2548
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/06/2017
Last updated
08/22/2018
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