Individual
MOLLY DEISROTH-KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
40 2ND AVE, SUITE 510, WALTHAM, MA 02451-1132
(781) 487-6103
Mailing address
20 GREEN WAY, WAYLAND, MA 01778-2626
(508) 358-4435
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
127683
IN
Other
Enumeration date
03/20/2012
Last updated
03/20/2012
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