Healthcare Provider Details

I. General information

NPI: 1841376209
Provider Name (Legal Business Name): KIMBERLY C. SMITH-ORICCHIO P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY ORICCHIO PT

II. Dates (important events)

Enumeration Date: 10/28/2006
Last Update Date: 08/26/2022
Certification Date: 08/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12315 N VISTOSO PARK RD
ORO VALLEY AZ
85755-5819
US

IV. Provider business mailing address

PO BOX 31630
TUCSON AZ
85751-1630
US

V. Phone/Fax

Practice location:
  • Phone: 520-544-9700
  • Fax: 520-618-6060
Mailing address:
  • Phone: 520-784-6200
  • Fax: 520-784-6390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number011903
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberLPT-31732
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: