Individual
KIMBERLY CONNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTH
Contact information
Practice address
407 N SHADY LN, DOTHAN, AL 36303-2946
(334) 673-7282
(334) 673-7283
Mailing address
407 N SHADY LN, DOTHAN, AL 36303-2946
(334) 673-7282
(334) 673-7283
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH3478
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51503542
BLUECROSS BLUE SHIELD
AL
Enumeration date
03/13/2007
Last updated
07/08/2007
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