Individual
KIMBERLY BLAIR LARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
410 NEW BRIDGE ST, SUITE 10-A, JACKSONVILLE, NC 28540-4739
(910) 347-2212
(910) 347-6003
Mailing address
410 NEW BRIDGE ST, SUITE 10-A, JACKSONVILLE, NC 28540-4739
(910) 347-2212
(910) 347-6003
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
10384
NC
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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