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NPI Code Detail

MEDICARE: SEAN KEHL ATC

MEDICARE: SEAN KEHL ATC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12255A2300XAthletic Trainer0506456NV

General Provider Information

NPI Number : 1174137442
Entity Type Code : Individual
Provider Name (Legal Business Name) : SEAN KEHL ATC
Provider Business Mailing Address
First Line : 4980 W SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-3402
Country : US
Telephone Number : 702-820-5070
Fax Number :
Provider Business Practice Location Address
First Line : 4980 W SAHARA AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-3402
Country : US
Telephone Number : 702-820-5070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/03/2020
Last Update Date : 09/03/2020

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Directions to “ SEAN KEHL ATC” Practice Location

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