The holder whose full name is Kim, Lisa M,come from Goshen IN,hold the Phys Ther Assistant license(NO.06002626A) which status is Active.
| Name | Kim, Lisa M |
|---|---|
| License Number | 06002626A |
| License Type | Phys Ther Assistant |
| License Status | Active |
| City | Goshen |
| State | IN |