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Individual

MISS KIMBERLY BAUTISTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
64-974 MAMALAHOA HWY STE 103, KAMUELA, HI 96743-7334
(808) 887-1371
Mailing address
PO BOX 6810, KAMUELA, HI 96743-6810
(808) 887-1371

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
34171
CA
2251X0800X
Orthopedic Physical Therapist
Primary
4152
HI

Other

Enumeration date
01/20/2016
Last updated
02/26/2016
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