Individual
MR. KERRY WIMBERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
4601 S. LOOP 289 #11, LUBBOCK, TX 79424
(806) 792-7200
(806) 792-7225
Mailing address
4601 S. LOOP 289 #11, LUBBOCK, TX 79424
(806) 792-7200
(806) 792-7225
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1390
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT1390
LICENSED ATHLETIC TRAINER
TX
Enumeration date
10/05/2006
Last updated
07/08/2007
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