Individual
KIMBERLY DAWN PATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1525 HERBERT ST STE 103, PORT ORANGE, FL 32129-6107
(386) 756-0424
Mailing address
1525 HERBERT ST STE 103, PORT ORANGE, FL 32129-6107
(386) 756-0424
(386) 756-0425
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
20023
FL
Other
Enumeration date
05/09/2018
Last updated
05/09/2018
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