Individual
MRS. KIMBERLY JENELLE NIETO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
4604 S SUGAR RD APT 821, EDINBURG, TX 78539-0146
(956) 358-0722
Mailing address
PO BOX 720774, MCALLEN, TX 78504-0774
(956) 994-8505
(956) 994-8586
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2162471
TX
Other
Enumeration date
05/04/2023
Last updated
05/04/2023
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