Provider Demographics
NPI:1083677801
Name:LAFOND, KERRI ANNE (ATC)
Entity Type:Individual
Prefix:MISS
First Name:KERRI
Middle Name:ANNE
Last Name:LAFOND
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 I COURT ST
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:580 COURT ST
Practice Address - Street 2:SPORTS MEDICINE CENTER
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431-1715
Practice Address - Country:US
Practice Address - Phone:603-354-6630
Practice Address - Fax:603-354-6636
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1902255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer