KIM B. POWERS, D.O., P.A.
Osteopathic Medicine at 66 St, Pinellas Park, FL

License number
Florida OS6697
Category
Osteopathic Medicine
Type
Adult Medicine
Owner
Name: KIM BARTHOLOMEW POWERS D.O.
Title: OWNER
Phone: (727) 541-0323
Address
Address
7800 66Th St N STE 105, Pinellas Park, FL 33781
National Provider ID: 1780955997
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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KIM B. POWERS, D.O., PA

Pinellas Park, FL  -  Clearwater, FL  -  Largo, FL

Registration:
Mar 1, 1999
Addresses:
7800 66 St N STE 105, Pinellas Park, FL 33781 (Physical)
202 Flamingo Dr, Clearwater, FL 33756 (Mailing)
12760 Indian Rocks Rd, Largo, FL 33774
State ID:
P99000020452
Business type:
Florida Profit Corporation
President, Director:
Kim B Powers (President, Director), 202 Flamingo Dr, Clearwater, FL 33756 (Physical)
Agent:
William Shaw,18395 Gulf Blvd, Indian Rocks Beach, FL 33785 (Physical)
EIN:
59-3563740

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