Individual
MISS KIMBERLY JO WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-4084
Mailing address
2500 E PROSPECT RD, FORT COLLINS, CO 80525-9718
(970) 493-4084
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/05/2007
Last updated
11/05/2007
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