Individual
KIMBERLY CORNWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M. S.
Contact information
Practice address
64 DEERWOOD CT, LAKE JACKSON, TX 77566-4457
(979) 236-5286
Mailing address
64 DEERWOOD CT, LAKE JACKSON, TX 77566-4457
(979) 236-5286
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
TX
Other
Enumeration date
02/25/2011
Last updated
02/25/2011
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