Individual
KRISTINE K BOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
29 TAYLOR AVE, 205, CROSSVILLE, TN 38555-4527
(931) 456-5757
(931) 456-5533
Mailing address
29 TAYLOR AVE, 205, CROSSVILLE, TN 38555-4527
(931) 456-5757
(931) 456-5533
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
6280
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6280
STATE LICENSE
TN
Enumeration date
07/26/2016
Last updated
07/26/2016
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