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Individual

MRS. KIMBERLY SUE BRYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
101 EUCALYPTUS AVE, CRESCENT CITY, FL 32112-2407
(386) 698-0841
(386) 698-0845
Mailing address
104 CATHY LN, CRESCENT CITY, FL 32112-4122
(315) 897-6597

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
012557-01
NY
225X00000X
Occupational Therapist
Primary
20540
FL

Other

Enumeration date
01/27/2022
Last updated
02/24/2022
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