Individual
KIMBERLY A EGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1275 COURTYARD PL, CENTERVILLE, OH 45458-3957
(937) 225-4500
Mailing address
1275 COURTYARD PL, CENTERVILLE, OH 45458-3957
(937) 885-0614
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT001909
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0413358
—
OH
Enumeration date
02/03/2011
Last updated
12/22/2020
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