Individual
TARA KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6800 PARK TEN BLVD, SAN ANTONIO, TX 78213-4211
(210) 734-6050
Mailing address
2415 ROGERS ISLE, SAN ANTONIO, TX 78258-4604
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
206468
TX
Other
Enumeration date
03/19/2007
Last updated
07/08/2007
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