Individual
KRISTEN SOUDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2003 VETERANS BLVD, GEORGETOWN, OH 45121-7408
(937) 515-0997
Mailing address
580 EBRITE RD, WEST UNION, OH 45693-9709
(937) 515-0997
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
005562
OH
Other
Enumeration date
10/14/2018
Last updated
10/14/2018
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