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1720157233
KRISTINE SUPPLE
OXNARD, CA
NPI
1720157233
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: CA 15019)
Enumeration Date
2006-11-07
Last Update Date
2007-07-09
Business Address
-- KRISTINE SUPPLE PA
2921 SAVIERS RD
OXNARD, CA 93033-5314
Phone number: 805-487-5588
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Mailing Address
-- KRISTINE SUPPLE PA
2705 LOMA VISTA RD SUITE 205
VENTURA, CA 93003-1581
Phone number: 805-667-2801
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