Individual
DR. KIMBERLY WOOD STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
649 CLINTON AVE, BRIDGEPORT, CT 06605-1711
(203) 336-2444
(203) 336-2422
Mailing address
649 CLINTON AVE, BRIDGEPORT, CT 06605-1711
(203) 336-2444
(203) 336-2422
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
CT2203
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004095669
—
CT
Enumeration date
02/07/2007
Last updated
05/04/2011
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