Healthcare Provider Details

I. General information

NPI: 1356602304
Provider Name (Legal Business Name): KIMBERLY RIMKA-MORRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2012
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44682 MORLEY DR
CLINTON TWP MI
48036-1358
US

IV. Provider business mailing address

44682 MORLEY DR
CLINTON TWP MI
48036-1358
US

V. Phone/Fax

Practice location:
  • Phone: 586-421-4062
  • Fax: 586-421-4072
Mailing address:
  • Phone: 586-421-4062
  • Fax: 586-421-4072

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: