Individual
MISS KATHRYN HAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1402 S 1ST ST, CHAMPAIGN, IL 61820-6916
(217) 333-6718
Mailing address
100 VILLAGE PARK WAY APT 205, SAVOY, IL 61874-7441
(513) 218-7336
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.004230
IL
Other
Enumeration date
02/02/2018
Last updated
02/02/2018
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