Individual
MS. KIMBERLY ANN BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3301 N PARK BLVD, BEAUMONT SCHOOL, CLEVELAND HEIGHTS, OH 44118-4258
(440) 223-3292
Mailing address
11694 PROSPECT RD, STRONGSVILLE, OH 44149-2928
(440) 572-0126
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-015
OH
Other
Enumeration date
04/10/2006
Last updated
09/03/2013
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