Logue, Kimberly S

Logue, Kimberly S is an sole proprietor health care provider with primary practice located at 3737 Roscommon N , Martinez GA 30907-4741. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Logue, Kimberly S can be contacted via phone (706) 860-9996.

Contact Information

Primary practice address
3737 Roscommon N Martinez GA 30907-4741
Phone: (706) 860-9996
Fax: (706) 868-7497
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X OT000986 Georgia

Profile Details

NPI number 1487719159
LBN Legal business name Logue, Kimberly S
Credentials OTRL
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 23rd, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487719159 NPPES
Georgia Other 339851 WELLCARE

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