Individual
KIMBERLY MAE TIMMERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
237 BRANDON RD, CLINTON, SC 29325-5605
(864) 200-5143
Mailing address
237 BRANDON RD, CLINTON, SC 29325-5605
(864) 200-5143
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
293255605
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3KY3-G16-XH13
—
SC
Enumeration date
06/03/2021
Last updated
06/03/2021
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