Individual
MRS. KIMBERLY LYNNE VICTORA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC, CSCS, PES
Contact information
Practice address
3111 GUNDERSEN DR, NC1-002, ONALASKA, WI 54650-8447
(608) 775-8600
Mailing address
114 GRISWOLD AVE, WEST SALEM, WI 54669-9284
(608) 775-8600
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1562
MN
2255A2300X
Athletic Trainer
Primary
221-039
WI
Other
Enumeration date
09/09/2005
Last updated
12/06/2011
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