Individual
JAY S KIMBRO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPSGT
Contact information
Practice address
125 E MAIN ST, STEVENSVILLE, MD 21666-4001
(865) 771-9123
Mailing address
125 E MAIN ST, STEVENSVILLE, MD 21666-4001
(865) 771-9123
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
PSN000036
DC
Other
Enumeration date
04/28/2020
Last updated
04/28/2020
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