Individual
KIMBERLY DIANE EDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5050 WINDSOR GREEN WAY UNIT 104, MYRTLE BEACH, SC 29579-1810
(843) 325-6278
Mailing address
5050 WINDSOR GREEN WAY UNIT 104, MYRTLE BEACH, SC 29579-1810
(843) 325-6278
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1057
SC
Other
Enumeration date
07/26/2021
Last updated
07/26/2021
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