Individual
TYLER KIMBAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 773-0040
(207) 661-4630
Mailing address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 773-0040
(207) 667-4630
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT 540
ME
Other
Enumeration date
09/20/2016
Last updated
08/09/2019
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