Individual
KELLY JEAN DIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
1025 NEW MOODY LN, LAGRANGE, KY 40031-9154
(502) 222-3303
Mailing address
5203 MARY CLAYTON LN, CRESTWOOD, KY 40014-8602
(502) 773-0686
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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