Individual
KELLY HALEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
7130 HORTON FIELDHOUSE, NORMAL, IL 61790
(309) 438-7246
Mailing address
1534 HUNT DR APT A, NORMAL, IL 61761-6117
(407) 506-8376
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.002482
IL
Other
Enumeration date
04/04/2012
Last updated
04/04/2012
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