Individual
KRISTY R STATEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.T.
Contact information
Practice address
37 ERICKSON RD, SANDIA PARK, NM 87047-9300
(505) 281-9605
Mailing address
37 ERICKSON RD, SANDIA PARK, NM 87047-9300
(505) 281-9605
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
043
NM
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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