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General NPI Number Information
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NPI Number | 1043423106
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Entity Type | Individual
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Provider Name | KIMBERLY ANN KROM LMP
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5219 W CLEARWATER AVE SUITE 9
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City | KENNEWICK
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State | WA
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Zip | 99336-1914
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Country | US
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Telephone | 509-736-6605
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Fax |
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Provider Business Mailing Address
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Address Line | 806 W 40TH PL
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City | KENNEWICK
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State | WA
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Zip | 99337-4415
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Country | US
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Telephone | 509-582-6014
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA00021094
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License Number State | WA
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