Individual
KIMBERLY PLAZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
500 E COLLEGE ST, MARSHALL, MO 65340-3109
(660) 831-4195
Mailing address
1032 WINNSBORO LOOP, ROUND ROCK, TX 78664-3312
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
2017035329
MO
2255A2300X
Athletic Trainer
Primary
AT8610
TX
Other
Enumeration date
10/22/2017
Last updated
08/10/2023
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