Individual
DAVID LEE KIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1200 KENWOOD AVE, DULUTH, MN 55811-4199
(218) 723-5906
Mailing address
1200 KENWOOD AVE, DULUTH, MN 55811-4199
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2255A2300X
SPECIALIST/TECHNOLOGIST - ATHLETIC TRAINER
—
01
—
390200000X
STUDENT IN AN ORGANIZED HEALTH CARE EDUCATION/TRAINING PROGRAM
—
Enumeration date
09/20/2018
Last updated
09/20/2018
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