Individual
MRS. KIMBERLY JOANNE SHORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
1118 CORNELIA RD, ANDERSON, SC 29621-3317
(864) 225-8321
Mailing address
227 S PENDLETON ST STE B, EASLEY, SC 29640-3084
(864) 855-7030
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
SC4041
SC
225100000X
Physical Therapist
Primary
4041
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4273
—
SC
05
—
TH1071
—
SC
Enumeration date
03/01/2006
Last updated
10/28/2022
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