Individual
KIM CHAMPINE YOURICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBA, PT
Contact information
Practice address
4411 SUWANEE DAM RD, SUITE 330, SUWANEE, GA 30024-8701
(770) 904-2332
Mailing address
3400 MAINSTAY PL, ALPHARETTA, GA 30022-2417
(678) 366-0183
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1031870
TX
225100000X
Physical Therapist
Primary
PT006404
GA
Other
Enumeration date
12/17/2013
Last updated
12/17/2013
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