Individual
MS. KELLY MICHELLE MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1250 SISKIYOU BLVD, ASHLAND, OR 97520-5001
(541) 552-5042
(541) 552-6543
Mailing address
760 JAQUELYN ST, ASHLAND, OR 97520-3782
(541) 488-0949
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATAT844109
OR
Other
Enumeration date
01/02/2007
Last updated
07/08/2007
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