Individual
ANN KLINKUSOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
485 ARSENAL ST, WATERTOWN, MA 02472-5091
(617) 972-5100
Mailing address
485 ARSENAL ST, WATERTOWN, MA 02472-5091
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN2269963
MA
Other
Enumeration date
10/11/2011
Last updated
10/11/2011
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