Individual
KIMBERLY COFFEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
(785) 239-3627
Mailing address
4110 FLORIDA ST, ZACHARY, LA 70791-3806
(601) 498-4203
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
24-01791
KS
2255A2300X
Athletic Trainer
301376
LA
Other
Enumeration date
10/18/2016
Last updated
09/19/2024
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