| NPI | 1366928004 |
|---|---|
| Former Name | KIMBERLY T. WENTWORTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MA 23873) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2023-07-27 |