Individual
MRS. KIMBERLY SALMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
1910 E MCCORD ST, CENTRALIA, IL 62801-6586
(618) 533-5416
Mailing address
1910 E MCCORD ST, CENTRALIA, IL 62801-6586
(618) 533-5416
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
057002487
IL
Other
Enumeration date
11/07/2013
Last updated
11/07/2013
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