Individual
KELLIE NICOLE WAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC, LAT, CSCS
Contact information
Practice address
3401 TECHNOLOGICAL AVE, SUITE 1, ORLANDO, FL 32817
(407) 681-2520
(407) 649-1414
Mailing address
1378 MEADOW LARK DR, TITUSVILLE, FL 32780-7164
(321) 298-8247
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL 2301
FL
Other
Enumeration date
06/25/2009
Last updated
12/21/2012
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