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General NPI Number Information
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NPI Number | 1255642013
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Entity Type | Individual
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Provider Name | KIMBERLY TODARO
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Gender | Female
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Dates
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Enumeration Date | 06/27/2010
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Last Update Date | 06/15/2021
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Provider Practice Location Address
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Address Line | 3053 NEW GERMANY RD SUITE 102
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City | EBENSBURG
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State | PA
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Zip | 15931-3516
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Country | US
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Telephone | 814-472-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 134 SPRUCE CT SUITE 102
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City | SALIX
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State | PA
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Zip | 15952-9424
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Country | US
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Telephone |
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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 | PT020644
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License Number State | PA
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