Individual
KIMBERLY SAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5830 CORAL RIDGE DR, SUITE 120, CORAL SPRINGS, FL 33076-3392
(866) 425-5768
Mailing address
5830 CORAL RIDGE DR, SUITE 120, CORAL SPRINGS, FL 33076-3392
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2004002572
MO
Other
Enumeration date
04/04/2014
Last updated
04/04/2014
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