Individual
KIM SCOVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
424 TERRACE CREEK CT, LEBANON, OH 45036-8118
(937) 238-4621
Mailing address
424 TERRACE CREEK CT, LEBANON, OH 45036-8118
(937) 238-4621
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09108
OH
Other
Enumeration date
08/11/2014
Last updated
08/11/2014
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