Individual
MRS. KIMBRA SUZANNE EDGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
11190 MEDLOCK BRIDGE RD, DULUTH, GA 30097-2578
(678) 849-5847
Mailing address
45 DOVER CLIFF WAY, JOHNS CREEK, GA 30022-3202
(678) 849-5847
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT002070
GA
Other
Enumeration date
04/23/2012
Last updated
02/07/2020
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