KRISJAN MIKKEL HENDERSON

WATERLOO, IA
NPI1831880152
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IA  133126)
Enumeration Date2023-05-17
Last Update Date2025-06-24
Business Address
KRISJAN MIKKEL HENDERSON MAT, LAT, ATC
604 ANSBOROUGH AVE
WATERLOO, IA 50701-5842
Phone number: 319-433-0130
Mailing Address
KRISJAN MIKKEL HENDERSON MAT, LAT, ATC
1106 KENT CIR APT 7
WATERLOO, IA 50701-4479
Phone number: 515-829-6540
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