Individual
KIMBERLY BANTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 2ND ST N STE E, SAFETY HARBOR, FL 34695-3503
(727) 712-0808
Mailing address
801 2ND ST N, SAFETY HARBOR, FL 34695-3517
(727) 712-0808
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA27104
FL
Other
Enumeration date
12/05/2017
Last updated
09/13/2024
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