Individual
KRISTEN LEIGH MOEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1700 W STOUT ST, RICE LAKE, WI 54868-5000
(715) 236-6408
Mailing address
1700 W. STOUT ST., RICE LAKE, WI 54868
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1234-019
WI
Other
Enumeration date
04/01/2008
Last updated
04/01/2008
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