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NPI Code Detail

MEDICARE: LAURA ELIZABETH KENTER M.S., A.T.C.

MEDICARE:   LAURA ELIZABETH KENTER  M.S., A.T.C.
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 TrainerIL

General Provider Information

NPI Number : 1659334233
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA ELIZABETH KENTER M.S., A.T.C.
Provider Business Mailing Address
First Line : 1807 CONTINENTAL AVE
Second Line : APT 202
City : NAPERVILLE
State : IL
Zip : 60563-4014
Country : US
Telephone Number : 630-803-5576
Fax Number :
Provider Business Practice Location Address
First Line : 5700 COLLEGE RD
Second Line : ATHLETIC TRAINING
City : LISLE
State : IL
Zip : 60532-2851
Country : US
Telephone Number : 630-829-6152
Fax Number : 630-960-0899
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2006
Last Update Date : 07/08/2007

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Directions to “ LAURA ELIZABETH KENTER M.S., A.T.C.” Practice Location

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