Individual
CARRIE LEIGH KWIATKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 884-0406
Mailing address
7126 COLUMBUS AVE, RICHFIELD, MN 55423-3314
(218) 830-0597
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2635
MN
Other
Enumeration date
12/30/2019
Last updated
12/30/2019
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