Individual
KIMBERLY A WATESKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
3211 E MOORES PIKE, BLOOMINGTON, IN 47401-7129
(812) 334-7604
(812) 334-7705
Mailing address
2436 E CANADA DR, BLOOMINGTON, IN 47401
(812) 334-3010
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008103A
PA
Other
Enumeration date
08/07/2012
Last updated
08/17/2012
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