Individual
KIMBERLY BUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
208 S MAIN AVE, LAKE PLACID, FL 33852-1810
(954) 696-7699
Mailing address
2233 CLIFTON ST, SEBRING, FL 33875-6444
(954) 696-7699
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA24151
FL
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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