Individual
KIMBERLY STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3425 EXECUTIVE PKWY, SUITE 128, TOLEDO, OH 43606-1326
(419) 537-0764
Mailing address
3425 EXECUTIVE PKWY, SUITE 128, TOLEDO, OH 43606-1326
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305005667
VA
Other
Enumeration date
01/05/2012
Last updated
01/05/2012
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