Individual
KIMBERLY K KOLB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1431 RUNNION AVE, FORT WAYNE, IN 46808
(260) 444-9207
Mailing address
1431 RUNNION AVE, FORT WAYNE, IN 46808-2592
(260) 444-9207
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
32001565A
IN
Other
Enumeration date
09/28/2017
Last updated
07/21/2022
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