Individual
MRS. KIMBERLY BLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
212 W 3RD ST SW, ROME, GA 30165-2802
(706) 295-4242
(706) 295-4260
Mailing address
365 S INDUSTRIAL BLVD, CALHOUN, GA 30701-3075
(706) 624-3000
(706) 624-3001
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT003333
GA
Other
Enumeration date
06/24/2008
Last updated
11/13/2017
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