Individual
TERRY R. KIMBALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
110 KIMBALL DR, LAFAYETTE, LA 70508-7802
(337) 344-7550
Mailing address
110 KIMBALL DR, LAFAYETTE, LA 70508-7802
(337) 344-7550
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
ATC.J00237
LA
Other
Enumeration date
05/25/2018
Last updated
05/25/2018
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