Individual
KIM UTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
719 W COKE RD, WINNSBORO, TX 75494-3011
(903) 342-3987
Mailing address
175 PRIVATE ROAD 7952, MINEOLA, TX 75773-5231
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2096525
TX
Other
Enumeration date
11/07/2019
Last updated
11/07/2019
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