Individual
KATHLEEN VESTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2298 LONGSTREET RD A, FORT BRAGG, NC 28310-0001
(910) 907-5063
Mailing address
3037 41ST AVENUE CT S, MOORHEAD, MN 56560-7473
(701) 936-1078
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2038
MN
Other
Enumeration date
07/30/2014
Last updated
07/27/2022
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