Individual
KRISTEN TETUAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
800 N SMITH RD APT 1L, BLOOMINGTON, IN 47408-2944
(419) 944-0623
Mailing address
800 N SMITH RD APT 1L, BLOOMINGTON, IN 47408-2944
(419) 944-0623
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002008A
IN
Other
Enumeration date
01/30/2014
Last updated
01/30/2014
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