Individual
KIMBERLY T ETHRIDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1476 LONG GROVE DR, MT PLEASANT, SC 29464-7571
(843) 216-3535
Mailing address
1476 LONG GROVE DR, MT PLEASANT, SC 29464-7571
(843) 216-3535
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3000
SC
Other
Enumeration date
12/07/2009
Last updated
07/26/2011
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