Provider Demographics
NPI:1255967485
Name:WHEELAND, KALYNN MARIE (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:KALYNN
Middle Name:MARIE
Last Name:WHEELAND
Suffix:
Gender:F
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 ANCHOR CT
Mailing Address - Street 2:
Mailing Address - City:MC DONALD
Mailing Address - State:PA
Mailing Address - Zip Code:15057-2199
Mailing Address - Country:US
Mailing Address - Phone:570-560-1994
Mailing Address - Fax:
Practice Address - Street 1:11 TROJAN WAY
Practice Address - Street 2:
Practice Address - City:COAL CENTER
Practice Address - State:PA
Practice Address - Zip Code:15423-1059
Practice Address - Country:US
Practice Address - Phone:724-785-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0074792255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer