Individual
KIMBERLY CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
101 S KRAEMER BLVD STE 125, PLACENTIA, CA 92870-6100
(714) 624-2315
Mailing address
101 S KRAEMER BLVD STE 125, PLACENTIA, CA 92870-6100
(714) 624-2315
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
21109
CA
Other
Enumeration date
10/06/2009
Last updated
08/23/2019
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