Individual
KIMBERLY BARRACO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6195 SQUARE LAKE DR, KIMBALL, MI 48074-1369
(810) 488-5935
Mailing address
6195 SQUARE LAKE DR, KIMBALL, MI 48074-1369
(810) 488-5935
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703111418
MI
Other
Enumeration date
12/01/2014
Last updated
12/01/2014
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