Individual
KRISTA MARIA KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
150 S ROOSEVELT RD APT 1029, MESA, AZ 85202-1076
(925) 699-1101
Mailing address
150 S ROOSEVELT RD APT 1029, MESA, AZ 85202-1076
(925) 699-1101
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1476
AZ
Other
Enumeration date
04/16/2018
Last updated
04/16/2018
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