MEDICARE: KIMBERLY ROWLAND

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	A012718	KY

General Provider Information

NPI Number	:	1528739240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY ROWLAND

Provider Business Mailing Address
First Line	:	976 VANHOOSER RD
Second Line	:
City	:	GRAND RIVERS
State	:	KY
Zip	:	42045-9162
Country	:	US
Telephone Number	:	270-562-0422
Fax Number	:

Provider Business Practice Location Address
First Line	:	976 VANHOOSER RD
Second Line	:
City	:	GRAND RIVERS
State	:	KY
Zip	:	42045-9162
Country	:	US
Telephone Number	:	270-562-0422
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2021
Last Update Date	:	09/22/2021

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Directions to “ KIMBERLY ROWLAND ” Practice Location

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