Individual
MRS. LESLIE ANNE KIMBRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
4852 OLD ALMA RD, BLACKSHEAR, GA 31516-4521
(912) 337-5588
Mailing address
4852 OLD ALMA RD, BLACKSHEAR, GA 31516-4521
(912) 337-5588
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
1212716
TX
174400000X
Specialist
19645
MA
174400000X
Specialist
3555
NH
174400000X
Specialist
Primary
PT006329
GA
Other
Enumeration date
07/25/2012
Last updated
07/25/2012
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