Individual
KIMBERLY ANN CHARLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
219 N.KING ST., ALICE, TX 78332
(361) 460-0979
Mailing address
P.O. BOX 423, BEN BOLT, TX 78342
(361) 460-0979
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2054070
TX
Other
Enumeration date
10/14/2019
Last updated
10/14/2019
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