Individual
MISS KALLI VANDENHEUVEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
W3068 KORTNEY LANE, SEYMOUR, WI 54165
(920) 843-2987
Mailing address
W3068 KORTNEY LN, SEYMOUR, WI 54165-8554
(920) 843-2987
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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