Individual
MS. KIM BARBARA PROBST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
159 INDIAN HEAD RD, COMMACK, NY 11725-2205
(631) 543-4500
(631) 543-5162
Mailing address
1 SUPERIOR ST, PORT JEFFERSON STATION, NY 11776-4329
(631) 474-1776
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1068
NJ
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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