Individual
KIMBERLY REY ROACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT, L/OTR
Contact information
Practice address
250 NW 76TH DR, GAINESVILLE, FL 32607-6668
(352) 505-6363
Mailing address
10502 NW 47TH TER, GAINESVILLE, FL 32653-7835
(352) 222-3409
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
MA67664
FL
225XP0200X
Pediatric Occupational Therapist
Primary
17463
FL
Other
Enumeration date
10/11/2012
Last updated
01/05/2016
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