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1043988116
TANNER C KIMBLE
VICKSBURG, MS
NPI
1043988116
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
246ZC0007X Specialist/Technologist, Other, Surgical Assistant
(Licence: 188016)
Enumeration Date
2021-09-02
Last Update Date
2022-02-15
Business Address
TANNER C KIMBLE CST/CSFA
2100 HIGHWAY 61 N
VICKSBURG, MS 39183-8211
Phone number: 601-883-5000
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Mailing Address
TANNER C KIMBLE CST/CSFA
406 LACASA LOOP
TWIN FALLS, ID 83301-5663
Phone number: 208-410-0569
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