Individual
KENNY RAY KIMBALL II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1410 N RACE ST, GLASGOW, KY 42141-3473
(270) 651-7882
Mailing address
249 LOVERS LN, GLASGOW, KY 42141-1000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
006743
KY
Other
Enumeration date
12/02/2015
Last updated
12/02/2015
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