Individual
MR. KIM A BISSONNETTE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MA ATC CSCS
Contact information
Practice address
3 KEANEY RD, SUITE 1, KINGSTON, RI 02881-1111
(401) 874-5230
(401) 874-5354
Mailing address
43 GREENWOOD DR, WAKEFIELD, RI 02879-1512
(401) 874-5230
(401) 874-5354
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
67
RI
Other
Enumeration date
02/17/2006
Last updated
07/08/2007
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