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Individual
DR. LYNDE HARRISON KIMBALL
Active
Individual
DR. LYNDE HARRISON KIMBALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
030-0000113
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-0298152
FED. ID #
VT
05
—
7910
—
VT
01
—
KIMB 077-6175
BC/BS
VT
Enumeration date
08/22/2006
Last updated
07/08/2007
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