Provider Demographics
NPI:1497890370
Name:KUESTER, KRISTEN (LMT CERTIFIED ROLFER)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:
Last Name:KUESTER
Suffix:
Gender:F
Credentials:LMT CERTIFIED ROLFER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1622 PASEO DE LA CONOVISTADORA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501
Mailing Address - Country:US
Mailing Address - Phone:505-989-7529
Mailing Address - Fax:505-989-7529
Practice Address - Street 1:1622 PASEO DE LA CONOVISTADORA
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501
Practice Address - Country:US
Practice Address - Phone:505-989-7529
Practice Address - Fax:505-989-7529
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM260225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist