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Individual

ALEXIS KATELYNN PROWKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
133 N RIVER ST, WILKES BARRE, PA 18711-0800
(570) 208-5925
Mailing address
1590 STATE RD, COOPERSBURG, PA 18036-9626
(267) 347-0721

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
390200000X
Student in an Organized Health Care Education/Training Program
Primary

Other

Enumeration date
08/27/2020
Last updated
08/27/2020
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