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General NPI Number Information
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NPI Number | 1376980433
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Entity Type | Individual
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Provider Name | KEVIN JAMES KAMLOWSKY ATC
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Gender | Male
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 10/14/2014
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Provider Practice Location Address
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Address Line | 1025 RISMAN DR 281 MAC CENTER
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City | KENT
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State | OH
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Zip | 44242-0001
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Country | US
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Telephone | 330-672-1170
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Fax | 330-672-9328
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Provider Business Mailing Address
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Address Line | 1025 RISMAN DR 281 MAC CENTER PO BOX 5190
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City | KENT
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State | OH
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Zip | 44242-0001
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Country | US
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Telephone | 330-672-1170
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Fax | 330-672-9328
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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 | AT.003352
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License Number State | OH
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