Individual
KIMBERLY OUTLAW-CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1906 BROWN AVE, PANAMA CITY, FL 32405-1130
(850) 625-0773
Mailing address
1906 BROWN AVE, PANAMA CITY, FL 32405-1130
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA50175
FL
Other
Enumeration date
03/28/2008
Last updated
03/28/2008
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