Individual
KIMBERLY A IZZO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
806 RIDGE CREEK LN, WOODSTOCK, GA 30189-6207
(404) 509-7986
(770) 517-8107
Mailing address
PO BOX 2848, ACWORTH, GA 30102-0015
(404) 509-7986
(770) 517-8107
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
005690
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000859064F
—
GA
Enumeration date
11/11/2006
Last updated
09/21/2014
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