Individual
DR. LYNDE HARRISON KIMBALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1222 PUTNEY RD, BRATTLEBORO, VT 05301-9062
(802) 254-6900
(802) 254-7610
Mailing address
PO BOX 8427, BRATTLEBORO, VT 05304-8427
(802) 254-6900
(802) 254-7610
Taxonomy
Speciality
Code
Description
License number
State
152WV0400X
Vision Therapy Optometrist
Primary
030-0000113
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03-0298152
FED. ID #
VT
05
—
7910
—
VT
01
—
KIMB 077-6175
BC/BS
VT
Enumeration date
08/22/2006
Last updated
07/08/2007
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