NPI 1053089482

Kyeongtak Song, PHDATC

Practitioner Athletic Trainer Lexington, KY

Practice location

Address: 720 Sports Center Drive, Lexington, KY 40506-0001
Phone: (859) 323-9850
Mailing address: 2775 Polo Club Blvd Unit 305, Lexington, KY 40509-8362

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

Other Specialist/Technologist providers in Kentucky →

Registry record

NPI: 1053089482
Entity type: Individual
Sex (as registered): Male
NPI issued: 31 Aug 2021
Record last updated: 31 Aug 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.