Individual
KIMBERLY BODNAR CASTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, PHD, PCS
Contact information
Practice address
1100 OLD DAWSON VILLAGE RD E STE 10, DAWSONVILLE, GA 30534-3807
(608) 526-9888
(608) 526-9865
Mailing address
1100 OLD DAWSON VILLAGE RD E STE 10, DAWSONVILLE, GA 30534-3807
(678) 367-2382
(678) 805-8452
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT011273
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508092644
—
WI
05
—
40146300
—
WI
Enumeration date
06/03/2009
Last updated
07/19/2018
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