Individual
KIMBERLY ENNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
719 CLINTON PKWY, STE B, CLINTON, MS 39056-5245
(601) 924-7828
Mailing address
719 CLINTON PKWY, STE B, CLINTON, MS 39056-5245
(601) 924-7828
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0390
MS
Other
Enumeration date
08/31/2011
Last updated
07/08/2016
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