Kristopher Pallesen, PTA

NPI #1154791572 in Stockton, California

Provider Information

NPI Number: 1154791572
Entity Type: Individual
Name: Kristopher Pallesen, PTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: PTA
Enumeration Date: Sep 28, 2015
Last Updated: Sep 28, 2015

Practice Location

Address: 5910 PACIFIC AVE
City: Stockton
State: California
ZIP Code: 95207-4704
Phone: (209) 475-1000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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