Individual
KIM KRYSTAL KOIKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
3712 FIDDLERS CREEK DR., WAUKESHA, WI 53188
(314) 640-4724
Mailing address
2014 S 102ND ST APT 309, WEST ALLIS, WI 53227-1350
(314) 640-4724
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
001148
MO
2083X0100X
Occupational Medicine Physician
001148
MO
208VP0014X
Interventional Pain Medicine Physician
001148
MO
225X00000X
Occupational Therapist
Primary
6645-26
WI
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001148
ERGONOMICS/INJURY PREVENTION & OCCUPATIONAL THERAPY
MO
Enumeration date
03/23/2018
Last updated
06/07/2023
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