Individual
MRS. KIM BANDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
551 E STATION AVE, COOPERSBURG, PA 18036-2027
(484) 863-9220
Mailing address
551 E STATION AVE, COOPERSBURG, PA 18036-2027
(484) 863-9220
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
OC007396L
PA
252Y00000X
Early Intervention Provider Agency
OC007396L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164707840
—
PA
Enumeration date
10/13/2011
Last updated
12/04/2016
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