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1770523557
THEODORE PRINS KISTEMAKER
WINSTON SALEM, NC
NPI
1770523557
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: NC 103628)
Enumeration Date
2006-06-08
Last Update Date
2014-04-28
Business Address
-- THEODORE PRINS KISTEMAKER PA-C
3333 BROOKVIEW HILLS BLVD STE 207
WINSTON SALEM, NC 27103-5661
Phone number: 336-765-5250
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Mailing Address
-- THEODORE PRINS KISTEMAKER PA-C
1701 WESTCHESTER DR STE 850
HIGH POINT, NC 27262-7008
Phone number: 336-802-2400
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