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Individual

CELESTA KIMBLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1409 E LAKE MEAD BLVD, NORTH LAS VEGAS, NV 89030-7120
(702) 649-7711
Mailing address
9303 GILCREASE AVE UNIT 1141, LAS VEGAS, NV 89149-6110
(708) 374-4451

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-1179
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000000000
NV
Enumeration date
09/17/2021
Last updated
09/17/2021
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