Individual
MRS. KIMBERLY LYNN WAINWRIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8250 NW 193RD ST, STARKE, FL 32091-5845
(904) 964-8401
Mailing address
8250 NW 193RD ST, STARKE, FL 32091-5845
(904) 964-8401
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA22865
FL
Other
Enumeration date
01/23/2012
Last updated
01/23/2012
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