Individual
MS. KIMBERLY DIANN EDDINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4065 FLINTRIDGE DR, SUITE A, STONE MOUNTAIN, GA 30083-3122
(404) 274-5433
Mailing address
4065 FLINTRIDGE DR, STONE MOUNTAIN, GA 30083-3122
(404) 274-5433
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
CO077801
GA
1744P3200X
Prosthetics Case Management
Primary
MT010080
GA
225700000X
Massage Therapist
MT010080
GA
Other
Enumeration date
07/25/2015
Last updated
10/21/2016
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