Individual
MRS. KIMBERLY TOBERGTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR L
Contact information
Practice address
15802 N PARKVIEW PLACE, SURPRISE, AZ 85374-1234
(623) 238-0056
Mailing address
15422 N 177TH DR, SURPRISE, AZ 85388-3100
(623) 455-8613
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
3714
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146259
—
AZ
Enumeration date
02/07/2007
Last updated
07/08/2007
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