Individual
STEPHEN KIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
175 SAM SIBLEY DR., NATCHITOCHES, LA 71457
(913) 687-0679
Mailing address
5348 HICKORY HILL DR SE, SALEM, OR 97306-1600
(913) 687-0679
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2694625
OR
2255A2300X
Athletic Trainer
Primary
—
LA
Other
Enumeration date
01/31/2017
Last updated
05/05/2017
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