Individual
KIMBERLY BERNICE COLSON-NUGENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
600 S BROAD ST, KENNETT SQUARE, PA 19348-3346
(215) 863-1598
Mailing address
600 S BROAD ST, KENNETT SQUARE, PA 19348-3346
(215) 863-1598
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
TE1001461
PA
Other
Enumeration date
06/04/2013
Last updated
06/04/2013
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