Organization
DEVELOPMENTAL PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY CLARK PT (MPT/OWNER)
(714) 624-2315
Entity
Organization
Contact information
Practice address
101 S KRAEMER BLVD STE 125, PLACENTIA, CA 92870-6100
(714) 624-2315
Mailing address
101 S KRAEMER BLVD STE 125, PLACENTIA, CA 92870-6100
(714) 624-2315
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
—
—
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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