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Individual
KIMBERLY NICOLE RISTAU
Active
Individual
KIMBERLY NICOLE RISTAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
019695
PA
225100000X
Physical Therapist
Primary
031194
NY
225100000X
Physical Therapist
2305209156
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03100832
—
NY
Enumeration date
02/27/2009
Last updated
05/19/2022
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