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Individual

KRISTI BETH KOLEK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1100 N SAN FRANCISCO ST, FLAGSTAFF, AZ 86001-3260
(928) 779-7853
(928) 774-0508
Mailing address
485 N PINECLIFF DR, FLAGSTAFF, AZ 86001-3380
(928) 380-2611

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3807
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3807
STATE LISCENCE
AZ
05
420103
AZ
Enumeration date
02/19/2008
Last updated
12/06/2011
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