Individual
TRACI MARIE KRISTOFIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
601 E 14TH ST, SEDALIA, MO 65301-5972
(660) 826-8833
Mailing address
601 E 14TH ST, SEDALIA, MO 65301-5972
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2019008366
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2016
Last updated
06/20/2019
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