Provider Demographics
NPI:1336250372
Name:HUXEL, KELLIE C (PHD, LAT, ATC)
Entity Type:Individual
Prefix:DR
First Name:KELLIE
Middle Name:C
Last Name:HUXEL
Suffix:
Gender:F
Credentials:PHD, LAT, ATC
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Mailing Address - Street 1:C39 ARENA BLDG DEPARTMENT OF ATHLETIC TRAINING
Mailing Address - Street 2:INDIANA STATE UNIVERSITY
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47809-0001
Mailing Address - Country:US
Mailing Address - Phone:812-237-7694
Mailing Address - Fax:812-237-4368
Practice Address - Street 1:C39 ARENA BLDG DEPARTMENT OF ATHLETIC TRAINING
Practice Address - Street 2:INDIANA STATE UNIVERSITY
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47809-0001
Practice Address - Country:US
Practice Address - Phone:812-237-7694
Practice Address - Fax:812-237-4368
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN36001242A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer