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Individual

MRS. KIM MARIE CONKLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPT

Contact information

Practice address
9050 BROOKER DR, NEW PORT RICHEY, FL 34655-1207
(727) 505-0941
Mailing address
9050 BROOKER DR, NEW PORT RICHEY, FL 34655-1207
(727) 505-0941

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT 17809
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
884978100
FL
01
Y0408
BLUE CROSS & BLUE SHIELD
FL
Enumeration date
11/14/2006
Last updated
09/03/2025
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