Anthony Kimbrough SR. PTA

NPI 1720409212 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1720409212
Gender Male
Enumeration Date 12/30/2013
Last Updated 12/30/2013
Entity Type Individual
Active Over 2 years ago
Practice Location
2575 N DRAKE RD
KALAMAZOO MI, 49006-1358, US
Phone (269) 342-0206
Fax
Business Location
931 OAKLAND DR
KALAMAZOO MI, 49008-1202, US
Phone (810) 610-5497
Fax
Toxanomy
Taxonomy Code 225200000X
License State Michigan
License Number 5502002960
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According to our database, Mr. Anthony Kimbrough SR. PTA NPI is 1720409212, taxonomy code is 225200000X and license number is 5502002960, license state is located at Michigan. Anthony Kimbrough SR. PTA physically located at 2575 N Drake Rd, Kalamazoo MI, 49006-1358. NPI Number Anthony Kimbrough SR. PTA has the Individual type.

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1720409212 NPI number is provided on an as is basis without warranty of any kind. 1720409212 is maintained by the National Plan & Provider Enumeration System. The contents of Anthony Kimbrough SR. PTA are for informational purposes only.