Individual
KIMBERLY STANFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT, OCS
Contact information
Practice address
248 E CROGAN ST STE 5, LAWRENCEVILLE, GA 30046-5069
(770) 910-7227
(470) 221-1514
Mailing address
248 E CROGAN ST STE 5, LAWRENCEVILLE, GA 30046-5069
(770) 910-7227
(470) 221-1514
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
014919
GA
Other
Enumeration date
02/24/2020
Last updated
07/14/2022
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