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Individual

KRISTINE CARRIE KVISTBERG BECKER

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
1280 DISC DR, SHAKOPEE, MN 55379-1863
(952) 402-3480
Mailing address
5144 38TH AVE S, MINNEAPOLIS, MN 55417-1650
(612) 721-6295

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1378
MN

Other

Enumeration date
09/01/2005
Last updated
07/08/2007
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