Individual
DR. KIM L. WIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
125 SUNRISE HWY, WEST ISLIP, NY 11795-2009
(631) 422-0424
(631) 422-1076
Mailing address
1331 WAVERLY AVE, FARMINGVILLE, NY 11738-1354
(631) 736-8439
(631) 422-1076
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X006556
NY
Other
Enumeration date
03/27/2007
Last updated
07/08/2007
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