Healthcare Provider Details

I. General information

NPI: 1548939606
Provider Name (Legal Business Name): KIMBERLEY KRAMER ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2021
Last Update Date: 09/10/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PARK WEST BLVD STE 330
AKRON OH
44320-4226
US

IV. Provider business mailing address

1731 MORTUS DR
TWINSBURG OH
44087-1540
US

V. Phone/Fax

Practice location:
  • Phone: 330-835-5533
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT-001511
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: