Provider Demographics
NPI:1720380918
Name:WOJTONEK, KIMBERLY JEAN
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:JEAN
Last Name:WOJTONEK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 N DOUGHERTY DR
Mailing Address - Street 2:
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28307-2248
Mailing Address - Country:US
Mailing Address - Phone:910-496-5476
Mailing Address - Fax:910-568-3718
Practice Address - Street 1:336 N DOUGHERTY DR
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28307-2248
Practice Address - Country:US
Practice Address - Phone:910-496-5476
Practice Address - Fax:910-568-3718
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor