Individual
MRS. KIERSTEN PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
2621 BOXWOOD DR, WILMINGTON, DE 19810-1607
(302) 290-4067
Mailing address
2621 BOXWOOD DR, WILMINGTON, DE 19810-1607
(302) 290-4067
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
DE
2255A2300X
Athletic Trainer
—
NV
2255A2300X
Athletic Trainer
—
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/29/2016
Last updated
05/05/2024
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