Individual
MRS. KIRSTEN ETKA HALLSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1459 COVENTRY SQUARE DR, ANN ARBOR, MI 48103-6314
(734) 646-9172
Mailing address
1459 COVENTRY SQUARE DR, ANN ARBOR, MI 48103-6314
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
5501007498
MI
Other
Enumeration date
01/06/2013
Last updated
01/06/2013
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