Healthcare Provider Details

I. General information

NPI: 1033055454
Provider Name (Legal Business Name): KIMBERLY COLBERT LMBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 N NC 16 BUSINESS HWY
DENVER NC
28037-6005
US

IV. Provider business mailing address

885 N NC 16 BUSINESS HWY
DENVER NC
28037-6005
US

V. Phone/Fax

Practice location:
  • Phone: 704-526-6920
  • Fax:
Mailing address:
  • Phone: 704-526-6920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number5480
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: