Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1386739241 |
---|---|
Provider Name | Mrs. Kimmy Kay Bloch |
First Address | Beavercreek, OH 45430-2300 |
Second Address | Dayton, OH 45428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 08/07/2007 |