Individual
KIMBERLY POUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3453 SHORT ST, PORT CHARLOTTE, FL 33948-7418
(941) 391-4525
Mailing address
3453 SHORT ST, PORT CHARLOTTE, FL 33948-7418
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT13997
FL
Other
Enumeration date
02/03/2010
Last updated
02/03/2010
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