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1689686404
KENNETH B AHLSTROM
BREMERTON, WA
NPI
1689686404
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2006-08-12
Last Update Date
2007-07-08
Business Address
Mr. KENNETH B AHLSTROM ATC
6855 ILLAHEE RD NE
BREMERTON, WA 98311-9626
Phone number: 360-692-0956
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Mailing Address
Mr. KENNETH B AHLSTROM ATC
6855 ILLAHEE RD NE
BREMERTON, WA 98311-9626
Phone number: 360-692-0956
Copy
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