Individual
KIM FERMENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
844 PASSOVER RD, OSAGE BEACH, MO 65065-2834
(573) 348-2225
Mailing address
844 PASSOVER RD, OSAGE BEACH, MO 65065-2834
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2013003772
MO
Other
Enumeration date
09/23/2014
Last updated
09/23/2014
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