Individual
KIMBERLY OHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1008 AIRPORT RD, SUITE A, DESTIN, FL 32541-2823
(850) 837-3349
Mailing address
90 MARK ST, DESTIN, FL 32541-3566
(850) 654-1313
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA 18367
LICENSE #
FL
Enumeration date
08/30/2006
Last updated
06/17/2008
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