Provider Demographics
NPI:1497316327
Name:ROMO, KAYLEE (ATC)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:ROMO
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 1:2291 W ALASKA AVE
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-8715
Mailing Address - Country:US
Mailing Address - Phone:928-699-9609
Mailing Address - Fax:
Practice Address - Street 1:2291 W ALASKA AVE
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-8715
Practice Address - Country:US
Practice Address - Phone:928-699-9609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer