Individual
KIMBERLY A SQUIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
1415 MAPLE ST, EUDORA, KS 66025-9419
(615) 896-6400
Mailing address
1206 PEACH ST, EUDORA, KS 66025-9600
(615) 896-6400
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1103863
KS
Other
Enumeration date
11/14/2008
Last updated
11/14/2008
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