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Individual

KIMBERLY D MCDOUGAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
301 REASONER LN, RUSSELLVILLE, AR 72802-2201
(479) 970-2175
(479) 964-2126
Mailing address
301 REASONER LN, RUSSELLVILLE, AR 72802-2201
(479) 970-2175
(479) 964-2126

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2203
AR

Other

Enumeration date
08/21/2006
Last updated
01/06/2008
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