Individual
KIMBRA FUESTING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
110 HORTON FIELD HOUSE, CAMPUS BOX 7130, NORMAL, IL 61790-0001
(309) 438-0647
(309) 438-2131
Mailing address
110 HORTON FIELD HOUSE, CAMPUS BOX 7130, NORMAL, IL 61790-0001
(309) 438-0647
(309) 438-2131
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.002604
IL
Other
Enumeration date
12/05/2011
Last updated
07/21/2016
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