Individual
ANDREA DICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4100 GRAF DR, LOUISVILLE, KY 40220-3017
(502) 593-4160
Mailing address
4100 GRAF DR, LOUISVILLE, KY 40220-3017
(502) 593-4160
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
36001285A
IN
2255A2300X
Athletic Trainer
Primary
AT483
KY
Other
Enumeration date
04/04/2016
Last updated
04/04/2016
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