Individual
KIMBERLY DAYON KINKITO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 ADAMS AVE, LA GRANDE, OR 97850-9532
(646) 522-5266
Mailing address
1205 ADAMS AVE, APT. # 7, LA GRANDE, OR 97850-2650
(646) 522-5266
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5542
OR
Other
Enumeration date
05/08/2008
Last updated
04/28/2009
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