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General NPI Number Information
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NPI Number | 1356472690
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Entity Type | Individual
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Provider Name | KIP ALAN PALMATEER A.T.,C
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Gender | Male
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 94 OLEAN ST
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City | EAST AURORA
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State | NY
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Zip | 14052-2531
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Country | US
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Telephone | 716-828-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 9202 HAYES HOLLOW RD
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City | COLDEN
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State | NY
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Zip | 14033-9623
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Country | US
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Telephone | 716-941-5618
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 000529-1
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License Number State | NY
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