Individual
MS. KIMBERLY MARIE WASSENAAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RT(R), RPA/RA
Contact information
Practice address
2821 WILLOW TREE LN, UNIT D, FORT COLLINS, CO 80525-4785
(970) 420-1679
Mailing address
2821 WILLOW TREE LN, UNIT D, FORT COLLINS, CO 80525-4785
(970) 420-1679
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
326783/07CO 1317
CO
Other
Enumeration date
07/27/2007
Last updated
07/27/2007
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