Individual
KELLY WIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
660 N BROAD ST, ELM TERRACE GARDENS, LANSDALE, PA 19446-2361
(215) 362-6087
(215) 412-3495
Mailing address
125 HEDGEROW DR, SOUDERTON, PA 18964-1976
(215) 721-0384
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE001685L
PA
Other
Enumeration date
04/04/2007
Last updated
07/08/2007
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