Individual
MS. KIMBERLY J MAZZELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T
Contact information
Practice address
875 S VANGUARD WAY STE 110, MERIDIAN, ID 83642-8541
(208) 960-0932
(208) 960-0935
Mailing address
875 S VANGUARD WAY STE 110, MERIDIAN, ID 83642-8541
(208) 960-0930
(208) 960-0935
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-7231
ID
Other
Enumeration date
07/06/2006
Last updated
10/26/2022
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