Individual
KIMBERLY MAYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
13609 CALIFORNIA ST, SUITE 200, OMAHA, NE 68154-5260
(402) 891-1118
Mailing address
PO BOX 275, SAINT MICHAEL, PA 15951-0275
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
A4374
MD
225200000X
Physical Therapy Assistant
Primary
TTEI001416
PA
Other
Enumeration date
11/12/2015
Last updated
11/12/2015
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