Individual
KIMBERLY DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
119 BASTILLE DR, PAGOSA SPRINGS, CO 81147-9388
(970) 731-4330
Mailing address
108 GALA PL, PAGOSA SPRINGS, CO 81147-9156
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
12802
CO
Other
Enumeration date
12/14/2012
Last updated
12/14/2012
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