Healthcare Provider Details

I. General information

NPI: 1952949794
Provider Name (Legal Business Name): KALEIGH HUNDLEY ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KALEIGH TOOLE ATC

II. Dates (important events)

Enumeration Date: 12/11/2019
Last Update Date: 11/27/2023
Certification Date: 12/11/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 SHELBYVILLE RD
ST MATTHEWS KY
40207-3149
US

IV. Provider business mailing address

513 HARRIS PL
LOUISVILLE KY
40222-6703
US

V. Phone/Fax

Practice location:
  • Phone: 502-895-9427
  • Fax:
Mailing address:
  • Phone: 413-204-7385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT1445
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: