Individual
KIA KUKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1575 HOOVER DR, NORTH MANKATO, MN 56003-2667
(507) 720-6582
Mailing address
18512 568TH AVE, MANKATO, MN 56001-6650
(417) 599-5139
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11267
MN
Other
Enumeration date
03/21/2022
Last updated
01/10/2023
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