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General NPI Number Information
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NPI Number | 1629504907
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Entity Type | Individual
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Provider Name | KATELYN MARY MUSIL LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 05/05/2017
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Last Update Date | 07/27/2017
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Provider Practice Location Address
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Address Line | 1600 CAMPUS CT
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City | ABILENE
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State | TX
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Zip | 79601-3761
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Country | US
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Telephone | 785-562-7450
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Fax |
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Provider Business Mailing Address
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Address Line | 745 STATE HIGHWAY 9
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City | BLUE RAPIDS
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State | KS
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Zip | 66411-8622
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Country | US
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Telephone | 785-562-7450
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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 | AT7175
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License Number State | TX
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