Kelley Lyn Etheridge, ATC

NPI #1073660759 in Hiram, Georgia

Provider Information

NPI Number
1073660759
Entity Type
Individual
Name
Kelley Lyn Etheridge, ATC
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Specialist/Technologist - Athletic Trainer
Credential
ATC
Enumeration Date
Jan 4, 2007
Last Updated
Jul 10, 2007

Practice Location

Address
52 WOODSFIELD LN
City
Hiram
State
Georgia
ZIP Code
30141-5165
Phone
(404) 218-9051

Specialties & Taxonomy Codes

Specialty
Specialist/Technologist - Athletic TrainerAthletic Trainer

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Organizations

Provider Name
Gcsu Athletic Training

Part of Georgia College & State University

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