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General NPI Number Information
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NPI Number | 1033707880
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Entity Type | Individual
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Provider Name | KRISTEN MARIE KING ATC
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Gender | Female
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Dates
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Enumeration Date | 01/07/2021
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 4000 RIDGEWAY DR
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City | BIRMINGHAM
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State | AL
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Zip | 35209-5563
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Country | US
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Telephone | 205-313-7435
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Fax |
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Provider Business Mailing Address
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Address Line | 243 HIGH RIDGE DR
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City | PELHAM
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State | AL
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Zip | 35124-4016
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Country | US
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Telephone | 609-947-4739
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 1071
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License Number State | AL
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