Individual
MOLLY KALEEN KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
721 W ROBERTSON ST STE 102, BRANDON, FL 33511-4900
(862) 676-8502
Mailing address
4630 MCINTOSH RD. SITE J-37, DOVER, FL 33527
(940) 867-8004
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
PTA30282
FL
225200000X
Physical Therapy Assistant
Primary
PTA30282
FL
Other
Enumeration date
11/02/2020
Last updated
02/27/2023
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