Individual
KIMBERLY POTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
540 KINGSLEY AVE, ORANGE PARK, FL 32073-4847
(904) 264-2156
Mailing address
405 INAGUA DR, SAINT AUGUSTINE, FL 32095-9613
(904) 824-6073
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT20035
FL
2255A2300X
Athletic Trainer
Primary
AL1021
FL
Other
Enumeration date
09/27/2006
Last updated
09/11/2025
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