Kelly Buckholz Smallbeck
Specialist/Technologist, Athletic Trainer in Spring, TX. Individual provider (NPI-1).
NPI number1366948903
StatusActive
Last updated in NPPESApr 3, 2018
Details
- NPI
- 1366948903
- Entity type
- Individual (NPI-1)
- Name
- Kelly Buckholz Smallbeck
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 3, 2018
- Last updated
- Apr 3, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AT6095 | TX | Yes |
Other names
- Kelly Buckholz (Former Name)
Practice location
19428 I-45 NorthSpring, TX 77373
Phone 281-891-7084 · Fax 281-891-7001
Mailing address
19428 I-45 NorthSpring, TX 77373
Phone 281-891-7084 · Fax 281-891-7001
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