Organization
KIMBERLEE J ODONALD PT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLEE J ODONALD PT (PRESIDENT)
(616) 754-7040
Entity
Organization
Contact information
Practice address
1330 W WASHINGTON, GREENVILLE, MI 48838-2190
(616) 754-7040
(616) 754-7888
Mailing address
1330 W WASHINGTON, GREENVILLE, MI 48838-2190
(616) 754-7040
(616) 754-7888
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2679020
—
MI
01
—
30435
BLUE CROSS BLUE SHIELD
MI
Enumeration date
01/02/2007
Last updated
08/22/2020
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