Healthcare Provider Details

I. General information

NPI: 1487764197
Provider Name (Legal Business Name): KIMBERLY M DUBOIS PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY PREVITI DUBOIS

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 S RIVER RD BEDFORD PLACE, UNIT 58
BEDFORD NH
03110-6719
US

IV. Provider business mailing address

40 S RIVER RD BEDFORD PLACE, UNIT 58
BEDFORD NH
03110-6719
US

V. Phone/Fax

Practice location:
  • Phone: 603-626-4205
  • Fax: 603-666-6617
Mailing address:
  • Phone: 603-626-4205
  • Fax: 603-666-6617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3159
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number3159
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: