Individual
MARY RICHEL KIMBROUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
355 OZARK TRAIL DR STE 1, ELLISVILLE, MO 63011-2164
(636) 207-2273
Mailing address
12401 E 37TH TER S, INDEPENDENCE, MO 64055-7101
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2019023929
MO
Other
Enumeration date
07/17/2019
Last updated
07/17/2019
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