NPI | 1265495261 |
---|---|
Former Name | JOY R. KIMBALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: KS 04-29125) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 04-29125) |
Enumeration Date | 2006-04-10 |
Last Update Date | 2025-09-11 |