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General NPI Number Information
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NPI Number | 1245556620
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Entity Type | Individual
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Provider Name | KIMBERLY K BYRD-RIDER MSPT
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Gender | Female
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Dates
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Enumeration Date | 04/11/2010
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Last Update Date | 02/21/2019
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Provider Practice Location Address
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Address Line | 2150 HOLLOW BROOK DR SUITE 100
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City | COLORADO SPRINGS
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State | CO
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Zip | 80918-8413
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Country | US
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Telephone | 719-599-5330
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Fax | 719-599-5438
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Provider Business Mailing Address
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Address Line | 37 EVERGREEN AVE
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City | KEY WEST
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State | FL
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Zip | 33040-6244
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Country | US
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Telephone | 970-306-1163
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Fax |
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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 | 10614
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License Number State | CO
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