Healthcare Provider Details

I. General information

NPI: 1568964971
Provider Name (Legal Business Name): KIMBERLY SUE ZIPPLE PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIMBERLY SUE ZIPPLE PT

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 03/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E MICHIGAN AVE
LANSING MI
48912-1811
US

IV. Provider business mailing address

6239 KAREN LEE DR
LANSING MI
48917-9258
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-2786
  • Fax:
Mailing address:
  • Phone: 517-364-2786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: