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Individual

CHERISSE COSTAS KUTYREFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC/L

Contact information

Practice address
1705 S. SAN FRANCISCO ST., FLAGSTAFF, AZ 86001
(928) 523-2139
(928) 523-0406
Mailing address
3601 LAKE MARY RD, #280, FLAGSTAFF, AZ 86001-9387

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0875
AZ

Other

Enumeration date
11/21/2011
Last updated
11/21/2011
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