Individual
KIMBLEY BOSWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Credential
LDO
Contact information
Practice address
4575 BELLADONNA ST, MIDDLEBURG, FL 32068-6017
(904) 334-6296
Mailing address
4575 BELLADONNA ST, MIDDLEBURG, FL 32068-6017
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
3002
FL
Other
Enumeration date
03/01/2025
Last updated
03/01/2025
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