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General NPI Number Information
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NPI Number | 1619528718
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Entity Type | Individual
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Provider Name | KAITLYN NEDROW MS, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 09/20/2019
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Last Update Date | 09/20/2019
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Provider Practice Location Address
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Address Line | 425 CREST AVE
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City | ROSTRAVER TOWNSHIP
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State | PA
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Zip | 15012-9660
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Country | US
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Telephone | 412-789-8648
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Fax |
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Provider Business Mailing Address
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Address Line | 3 MAIN ST
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City | DUNBAR
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State | PA
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Zip | 15431-1619
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Country | US
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Telephone |
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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 | RT007008
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License Number State | PA
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