KIMBERLY LARUE KWAN SHACKELFORD

SACRAMENTO, CA
NPI1760733356
Former NameKIMBERLY LARUE KWAN ASATO
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: CA  40045)
Additional Taxonomies225100000X Physical Therapist
(Licence: TX  1221081)
Enumeration Date2012-09-24
Last Update Date2015-03-10
Business Address
-- KIMBERLY LARUE KWAN SHACKELFORD DPT
3601 MARCONI AVE
SACRAMENTO, CA 95821-5309
Phone number: 916-481-1300
Mailing Address
-- KIMBERLY LARUE KWAN SHACKELFORD DPT
3171 RANCHO SILVA DR
SACRAMENTO, CA 95833-1132
Phone number: