Individual
MISS KIMBERLY MARIE MARTINCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT (TEMP LICENSE)
Contact information
Practice address
3395 PLYMOUTH RD, MINNETONKA, MN 55305-3765
(952) 939-0396
(952) 548-8760
Mailing address
3395 PLYMOUTH RD, MINNETONKA, MN 55305-3765
(952) 939-0396
(952) 548-8760
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
104254
MN
Other
Enumeration date
06/10/2012
Last updated
06/10/2012
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