Individual
KIMBERLY RENA STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
200 PATEWOOD DR, STE C150, GREENVILLE, SC 29615-3593
(864) 454-0904
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4278
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH1406
—
SC
Enumeration date
07/31/2006
Last updated
06/25/2024
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