Individual
KRISTEN LONGVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATS
Contact information
Practice address
907 N LOGAN ST, FREMONT, NE 68025-4300
(605) 620-0013
Mailing address
907 N LOGAN ST # 294, FREMONT, NE 68025-4300
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
979
NE
Other
Enumeration date
08/08/2019
Last updated
08/08/2019
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