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General NPI Number Information
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NPI Number | 1013465244
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Entity Type | Individual
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Provider Name | BETH KIMBALL DPT
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Gender | Female
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Dates
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Enumeration Date | 09/16/2016
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Last Update Date | 09/16/2016
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Provider Practice Location Address
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Address Line | 801 W JUDGE PEREZ DR SUITE A
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City | CHALMETTE
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State | LA
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Zip | 70043-4882
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Country | US
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Telephone | 504-278-7567
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Fax | 504-278-7569
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Provider Business Mailing Address
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Address Line | 801 W JUDGE PEREZ DR SUITE A
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City | CHALMETTE
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State | LA
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Zip | 70043-4882
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Country | US
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Telephone | 504-278-7567
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Fax | 504-278-7569
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 08386
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT5178
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License Number State | MS
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