Individual
KIMBERLY JEAN WILSHERE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
491 TALON DR, MOUNTVILLE, PA 17554-1328
(631) 680-5830
Mailing address
491 TALON DR, MOUNTVILLE, PA 17554-1328
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC011092
PA
Other
Enumeration date
08/06/2009
Last updated
08/06/2009
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