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Individual

KRISTINA BOSTROM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
14766 WASHINGTON AVE, SAN LEANDRO, CA 94578-4220
(510) 352-2211
Mailing address
1435 3RD AVE APT 104, OAKLAND, CA 94606-2262

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 9952
CA
225200000X
Physical Therapy Assistant
P160061350
WA

Other

Enumeration date
04/23/2013
Last updated
04/23/2013
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